• Clinical and Experimental Pediatrics
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• v.59 no.2
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• pp.100-103
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• 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.444-448
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• 1996

Hemolytic anemia due to tiny prosthetic paravalvular leakage is one of a complication of prosthetic valve replacement. Mild Hemolysls usually occurs after aortic valve replacement with mechanical valve but rarely occurs in mitral valve position especially in case of tissue valve. Cardiac valves fabricated from biologic material are associated with a reduced incidence of hemolytic anemia. Hemolysis was reported in patients with an lonescu-Shiley bovine pericardial xenograft prosthesis in the aortic position but not in the mitral site. A 41-year-old female patient was admitted due to sudden development dark colored urine. About 10 years ago the patient was underwent MVR (Mitral Valve Re lacement) with fTmm lonescu-Shiley valve due to MR (Mitral regurgitation). Echocardiographic examination showed mild degree of mitral regurgitation with valvular thickening. However, there was no definitive evidence of paravalvular leakage. The peripheral blood smear showed nomochromic normocytic anemia, but the hematologic and urinary examination revealed severe hemolytic evidence. Mitral valve replacement with St. Jude Medical valve (27mm) was done and intraoperatively, a tiny paravalvular leakage was found which was regarded as the point of hemolysis. The hemolytic evidence completely disappeared. We are reporting a case of severe hemolytic anemia due to tiny prosthetic paravalvular leakage with a review of the literature.

• Laboraroty Animal Research
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• v.34 no.4
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• pp.302-310
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• 2018

CD47 (integrin-associated protein), a multi-spanning transmembrane protein expressed in all cells including red blood cells (RBCs) and leukocytes, interacts with signal regulatory protein ${\alpha}$ ($SIRP{\alpha}$) on macrophages and thereby inhibits phagocytosis of RBCs. Recently, we generated a novel C57BL/6J CD47 knockout ($CD47^{-/-}$ hereafter) mouse line by employing a CRISPR/Cas9 system at Center for Mouse Models of Human Disease, and here report their hematological phenotypes. On monitoring their birth and development, $CD47^{-/-}$ mice were born viable with a natural male-to-female sex ratio and normally developed from birth through puberty to adulthood without noticeable changes in growth, food/water intake compared to their age and sex-matched wild-type littermates up to 26 weeks. Hematological analysis revealed a mild but significant reduction of RBC counts and hemoglobin in 16 week-old male $CD47^{-/-}$ mice which were aggravated at the age of 26 weeks with increased reticulocyte counts and mean corpuscular volume (MCV), suggesting hemolytic anemia. Interestingly, anemia in female $CD47^{-/-}$ mice became evident at 26 weeks, but splenomegaly was identified in both genders of $CD47^{-/-}$ mice from the age of 16 weeks, consistent with development of hemolytic anemia. Additionally, helper and cytotoxic T cell populations were considerably reduced in the spleen, but not in thymus, of $CD47^{-/-}$ mice, suggesting a crucial role of CD47 in proliferation of T cells. Collectively, these findings indicate that our $CD47^{-/-}$ mice have progressive hemolytic anemia and splenic depletion of mature T cell populations and therefore may be useful as an in vivo model to study the function of CD47.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.151-154
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• 2006

Acute toxic methemoglobinemia is an infrequent complication of the use of various drugs. Severe methemoglobinemia is very often fatal. Methylene blue is an effective drug in the treatment of methemoglobinemia patients. However, failure to respond to methylene blue has been described in patients with sulfhemoglobinemia, chlorate poisoning, and glucose-6-phosphate dehydrogenase deficiency. It is even possible that hemolysis may occur due to methylene blue treatment itself. We encountered a case of a 71-year-old woman who developed methemoglobinemia caused by alprazolam intoxication. She presented with hemolytic anemia and did not respond to methylene blue. In spite of concerted N-acetylcysteine therapy, the hemolytic anemia became aggravated and the patient died eleven days after intoxication.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.573-581
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• 2004

Evans syndrome, as originally described, refers to autoimmune hemolytic anemia accompanied by thrombocytopenia. The autoantibodies in Evans syndrome are directed specifically against red cells, platelets, or neutrophils and are not crossreacting. The incidence of autoimmune hemolytic anemia is estimated to be approximately 10 cases per million people. Many patients have associated disorders, such as lupus erythematosus and other autoimmune disease, chronic lymphadenopathy, or hypogammaglobulinemia. In Oriental Medicine, the approach to Evans syndrome is made in view of deficiency of blood. The ailment was treated through methods of Oriental Medicine. Acupucture and herbal medicine were administered to patients diagnosed with Evans Syndrome by ecchymosis at the lower limb after continued gingival bleeding. As a result significant improvement in RBC, Hb, Hct, and PLT were observed and complaints abated.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.237-242
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• 2001

The garlic has been eaten widely regardless of easten and westen countries to cure the various disease like cancer, tuberculosis, dentalgia, toxemia and leprosy from ancient times. Even now it is reported that they lower the level of triglycerides and cholesterol in blood and that they also affect on the cohesive power of the platelets. In addition, it is also known that it lowers the glucose level in blood. Especially, the sulfur containing amine acid and the derivatives of the garlic has the counteracting effect to heavy metals. Nowadays, the garlic is known for its efficiency for the various kinds of cancer, neoplasms, hypertension, arteriosclerosis and apoplexy. However, it is reported that the intake of the excessive amount of garlic causes hemolytic anemia recently. The hemolytic anemia is more severe especially in HK phenotype dogs which has Na-K-ATPase activity. Therefore, this study was performed to examine the effect on the blood of the HK phenotype Jindo dogs when administered the excessive amount of garlic. HK phenotype group showed the significant decrease on RBC, WBC, PCV, Hb, MCV, MCHC, GSH, Met-Hb but LK phenotype group didn's show the significant decrease. AST, ALT, BUN, creatinine, CPK, glucose, and total protein values were within normal ranges during the period.

• Parasites, Hosts and Diseases
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• v.58 no.5
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• pp.565-569
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• 2020

This report describes the first clinical case of a transfusion-associated Mycoplasma haemocanis infection in a dog in Korea. A 6-year-old male Maltese underwent a red blood cell transfusion for idiopathic immune-mediated hemolytic anemia. Eighteen days after the blood transfusion, the recipient's packed cell volume decreased and basophilic organisms were found on erythrocytes. A polymerase chain reaction and sequential analysis showed that both the donor dog and recipient dog had M. haemocanis. Six weeks after doxycycline administration, no organisms were detected and the recipient's anemia had improved.

• Journal of Veterinary Clinics
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• v.37 no.4
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• pp.223-226
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• 2020

Cytauxzoonosis is caused by Cytauxzoon felis (C. felis) in wild and domestic cats. However, cytauxzoonosis is uncommon in Asia. Additionally, clinical reports of C. felis infection along with associated complications are rare. A seven-year-old neutered male Maine Coon cat was presented with acute dyspnea and lethargy despite the absence of a history of overseas travel. Mild regenerative anemia and autoagglutination were detected in hematological investigations. The parasitic and viral PCR assays revealed infection with C. felis and feline immunodeficiency virus (FIV). Thoracic radiographs showed pleural effusion with secondary bacterial infection. Ultimately, a diagnosis of infection-induced secondary immune-mediated hemolytic anemia (IMHA) and pyothorax was established. The cat was treated with a combination of atovaquone, prednisolone, and cyclosporine over 6 months and the final treatment was completed 8 months after initiation of therapy. This is the first report of its kind demonstrating successful management of feline IMHA and fatal pyothorax induced by FIV and C. felis in South Korea.

• Journal of Medicine and Life Science
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• v.17 no.3
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• pp.103-106
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• 2020

Bone marrow failure, such as aplastic or myelophthisic anemia, can occur due to an underlying lymphoid malignancy and cause life-threatening events. A 58-year-old man diagnosed with angioimmunoblastic T-cell lymphoma had recently visited the emergency department because of an altered level of consciousness caused by acute severe anemia. The laboratory findings were strongly suggestive of bone marrow failure syndrome. Bone marrow examination was immediately performed and, subsequently, dexamethasone was initiated to control the underlying lymphoma. Intravenous immunoglobulin was also administered in combination due to combined immune hemolytic anemia and thrombocytopenia. Bone marrow examination revealed a packed marrow with marked fibrosis and lymphoma involvement. A diagnosis of secondary myelofibrosis related to the underlying lymphoma was made, and sequential combination chemotherapy was introduced despite the presence of severe anemia and thrombocytopenia. After combination chemotherapy, his hematologic profile and underlying lymphoma improved. Better understanding of various hematologic manifestations and knowledge of the rare condition of lymphoma are essential for appropriate diagnostic approaches and treatment.

• Korean Journal of Acupuncture
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• v.19 no.1
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• pp.67-75
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• 2002

목적 : 자성(雌性) 흰쥐에서 phenylhydrazine으로 유발된 용혈성 빈혈에 오미자 약침의 항빈혈효과를 알아보기 위해서 적혈구수, hematocrit ratio, hemoglobin, 혈청 철함유량 및 serum total iron binding capacity (TIBC)를 관찰하였다. 방법 : 실험동물은 정상군, 대조군, 250 mg/kg 오미자 투여군 및 500 mg/kg 오미자 투여군으로 총 4개의 군으로 분류하였다. 정상군의 흰쥐는 아무런 처치도 하지 않았고, 대조군은 phenylhydrazine으로 용혈성 빈혈을 유발하였다. 오미자 투여군은 용혈성 빈혈을 유발한 후 7일간 매일 250 mg/kg 및 500 mg/kg의 용량으로 중완혈에 자침하였다. 결과 : 적혈구수, hematocrit ratio 및 hemoglobin은 대조군에서 정상군에 비해 감소한 반면 오미자 투여군은 증가하였다. 혈청 철함유량과 TIBC는 대조군에서 증가하였으나, 오미자 투여군에서는 감소하였다. 이러한 결과로 중완혈에 오미자 자침은 phenylhydrazine으로 유발된 용혈성 빈혈에서 항빈혈효과가 있는 것으로 사려된다.