Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Gastric Mucosal Hemorrhage in a Patient with Idiopathic Thrombocytopenic Purpura

특발혈소판감소자색반병 환자에서 발생된 위점막 출혈 1예

  • Kim, Do-Hyung (Department of Internal Medicine, CHA University) ;
  • Kwon, Chang-Il (Department of Internal Medicine, CHA University) ;
  • Chung, Jun-Gu (Department of Internal Medicine, CHA University) ;
  • Park, Woong (Department of Internal Medicine, CHA University) ;
  • Kim, Yong-Hun (Department of Internal Medicine, CHA University) ;
  • Kang, Hae-Yoon (Department of Pathology, CHA University) ;
  • Ko, Kwang-Hyun (Department of Internal Medicine, CHA University) ;
  • Oh, Do-Yeun (Department of Internal Medicine, CHA University)
  • 김도형 (CHA 의과학대학교 내과학교실) ;
  • 권창일 (CHA 의과학대학교 내과학교실) ;
  • 정준구 (CHA 의과학대학교 내과학교실) ;
  • 박웅 (CHA 의과학대학교 내과학교실) ;
  • 김용훈 (CHA 의과학대학교 내과학교실) ;
  • 강혜윤 (CHA 의과학대학교 병리학교실) ;
  • 고광현 (CHA 의과학대학교 내과학교실) ;
  • 오도연 (CHA 의과학대학교 내과학교실)
  • Published : 2011.04.30
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Abstract

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune condition in which antibodies react against platelets and cause platelet destruction and bleeding that rarely results in gastrointestinal bleeding. Even though it is still controversial, a recent study suggested that Helicobacter pylori is one of the causes of ITP, and that eradication of H. pylori may be helpful for improving platelet count. We report a case of isolated gastric mucosal hemorrhage not related to H. pylori infection in a patient with ITP. A gastric mucosal biopsy revealed mild lamina proprial edema and extravasated red blood cells but no evidence of vasculitis or inflammatory cell infiltration. Thrombocytopenia can lead to a gastric mucosal hemorrhage not related to an H. pylori infection when treating patients with ITP.

특발혈소판감소자색반병(idiopathic thrombocytopenic purpura)은 혈소판 감소로 인하여 출혈의 증상이 나타날 수 있으며, 이러한 출혈의 증상은 주로 표재성 피부의 출혈로 나타나지만 비출혈이나 잇몸출혈도 발생할 수 있으며 드물게는 뇌출혈이나 소화기 출혈로 나타날 수 있다. 소화기 출혈의 경우에는 기저질환이나 알코올이나 약물 복용과 같은 출혈을 유발할 수 있는 다른 인자들에 대한 고려가 반드시 필요하다. 최근에는 헬리코박터균이 특발혈소판감소자색반병의 한 원인인자이며, 제균요법을 시행하는 것이 치료에 도움이 된다는 보고들이 있으나 아직까지 논란의 여지가 많다. 저자들은 특발혈소판감소자색반병 환자에서 발생한 위장관 출혈의 원인으로 헬리코박터균과 연관관계가 없는 위에만 국한된 점막 출혈 1예를 경험하였다. 고유의 조직학적인 특징을 확인하였고 혈소판 수의 증가로 자연적으로 호전되어 문헌고찰과 함께 보고한다.

Keywords

References

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