• Title/Summary/Keyword: 백혈구 감소증

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Isolated Leukopenia During Antituberculosis Treatment (1차 항결핵약제 치료 중 발생한 백혈구감소증의 추이)

  • Song, Heon-Ho;Lim, Chae-Man;Lee, Sang-Do;Go, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.420-427
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    • 2000
  • Background : Isolated leukopenia is rare, but it has important clinical implications during antituberculosis treatment. Inadvertent discontinuation of short-course regimen drugs for fear of leukopenia inevitably will extend the duration of treatment, and the completion of treatment will be delayed. However no guidelines concerning proper management for leukopenia during antituberculosis treatment have been presented. Therefore, this study was performed to evaluate the possibility of continuing the same short-course regimen if a mild-to-moderate degree of isolated leukopenia was to develop during antituberculosis treatment. Method : Thirty-six patients who had been prescribed a short-course antituberculosis regimen between January 1997 and August 1999, had newly developed, mild-to-moderate degree, isolated leukopenia during medication, and had continued the same drug regimen despite leukopenia were enrolled. One patient was not available for the follow-up, so the remaining thirty-five (twenty-five prospectively and ten retrospectively) patients were analyzed. Patients who had other known causes of leukopenia were excluded. A mild-to-moderate degree of isolated leukopenia was arbitrarily defined as having a peripheral blood leukocyte count between 2,000 and $3,499/mm^3$ and no evidence of coexisting hematologic abnormalities. Results : 1) All thirty-five patients were able to complete short-course anti-tuberculosis treatment without complication or further decrease of leukocytes count to less than $2,000/mm^3$ despite continuous treatment with the same regimen. 2) The mean duration from start of antitituberculosis medication to detection of leukopenia was $64{\pm}65$ days. 3) The mean leukocyte count was $5,035{\pm}1,583/mm^3$ before treatment, and the its lowest count was $2,908{\pm}390/mm^3$ during treatment. Leukopenia recovered after completion of treatment ($4,283{\pm}1,269/mm^3$). 4) The main component of leukopenia was the decrease in neutrophil count ($3,361{\pm}1,732$ vs. $1,512{\pm}423/mm^3$, p<0.05). Conclusion : For mild-to-moderate degree of isolated leukopenia ($2,000/mm^3{\leq}$ WBC < $3,500/mm^3$), developing during short-course antituberculosis treatment, the short-course antituberculosis regimen may be continued without complications.

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Lesions of Infectious Disease which is Characterized by Marked Leukopenia in Korea (백혈구 감소증을 특징으로 하는 돼지 전염성 질병의 육안적 병변)

  • Song Jae-Kuk;Lee Hyun-Beom;Lee Keun-Woo
    • Journal of the korean veterinary medical association
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    • v.29 no.2
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    • pp.104-112
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    • 1993
  • As an aid to diagnose the pig disease with marked leukopenia in Korea, 27 leukopenic(below/10,000/cmm)piggeries were autopsied. In addition, differential leukocyte counts for the leukopenic pigs and 12 healthy pigs were undertake. The results obtained are

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Prevalence of Feline Panleukopenia Virus in Stray and Household Cats in Seoul, Korea (한국의 서울에 사는 길 고양이와 집 고양이에서 고양이 범백혈구감소증 바이러스의 유병률)

  • Kim, Seung-Gon;Lee, Kyo-Im;Kim, Ha-Jung;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.30 no.5
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    • pp.333-338
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    • 2013
  • We investigated the prevalence of feline panleukopenia virus (FPV) in stray and household cats in different regions of Seoul, Republic of Korea. Blood samples were collected from a total of 200 cats (100 stray cats and 100 household cats) and examined by polymerase chain reaction (PCR). The overall prevalence of FPV was 2%. Among test-positive cats, 3% (3/100) were stray cats and 1% (1/100) was a household cat. The incidence of FPV was higher in juvenile cats (< 1 year, 1.5%) than in adult cats (> 1-year-old, 0.5%). The FPV-positive rates of healthy infected cats and sick cats were 1.9% (3/156) and 2.2% (1/44), respectively. We found the positive rate of vaccinated and unvaccinated cats to be 1.3% (1/77) and 2.4% (3/123), respectively. Unlike antibody tests, FPV antigen tests detected current infections in stray and household cats. Therefore, these tests can help in disease diagnosis and treatment. To our knowledge, our study is the first to survey the prevalence of FPV in different cat populations across Seoul. We found a high prevalence of FPV infection in stray and juvenile cats. Therefore, proper vaccination and surveillance are important to prevent FPV outbreaks.

Plasma G-CSF and GM-CSF Concentrations and Expression of their Receptors on the Granulocyte in Children with Leukocytosis (백혈구 증가증 환아의 혈장내 G-CSF와 GM-CSF의 농도 및 과립구에서의 이들 수용체의 발현)

  • Choi, Won Seok;Ryu, Kyung Hwan;Kim, You Jeong;Kim, So Young;Kim, Hyun Hee;Lee, Wonbae
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.271-276
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    • 2003
  • Purpose : Granulocyte-colony stimulating factor(G-CSF) and granulocyte macrophage-colony stimulating factor(GM-CSF) are principal cytokines in granulopoiesis and their physiologic effects are mediated through binding to specific cell surface receptors. Although it is known that the level of serum G-CSF and GM-CSF, and presentation of the receptors are increased in infectious diseases, there have been no studies to find the correlation between the granulopoiesis and leukocytosis. This study was designed to measure G-CSF and GM-CSF in leukocytosis and in control and to demonstrate the possible pathogenesis of granulopoiesis in leukocytosis using quantitative analysis of G-CSF, GM-CSF and their CSFr. Methods : The plasma levels of G-CSF, GM-CSF of 13 children without leukocytosis and 14 children with leukocytosis were measured. Counts of cell surface G-CSFr and GM-CSFr were measured by combining anti G-CSFr and anti GM-CSFr monoclonal antibodies to their respective receptors by using quantitative flow cytometric assay. Results : There was no significant difference betweeen the plasma concentration of G-CSF and GM-CSF in acute leukocytosis and in the control group. However, levels of G-CSFr in acute leukocytosis decreased significantly compared to the control(P=0.012) and the levels of GM-CSFr in both groups revealed no significant difference. Conclusion : Increase in the number of leukocyte in leukocytosis was mediated by increasing the number of neutrophil, and increased plasma concentration of G-CSF may be the cause of neutrophilia. But GM-CSF did not have any influence on leukocytosis.

Hematologic Studies of Peripheral Blood and Bone Marrow in Miliary Tuberculosis (속립성결핵환자에서 말초혈액 및 골수의 혈액학적 소견에 대한 연구)

  • Jeong, Jae-Man;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.654-659
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    • 1995
  • Background: Tuberculosis has commonly been associated with various hematologic changes. A difference between the changes found in pulmonary tuberculosis and those found in miliary tuberculosis has been discussed. Up to now some worker were investigated hematological changes associated with pulmonary tuberculosis but was not investigated those associated with miliary tuberculosis in korea. Therefore we examimed the peripheral blood and bone marrow findings in miliary tuberculosis patients to determine hematologic changes. Methods: We performed blood sample at admission and bone marrow biopsy within 7days after admission. For evaluation of the hematologic findings, full blood counts and marrow differential counts were defined by the criteria outlined by Dacie and Lewis. Results: 1) Peripheral blood findings: Pancytopenia in 10% of patients, anemia in all patients, leukocytosis in 10% of patients, leukopenia in 20% of patients, thrombocytopenia in 30% of patients, lymphocytopenia in 90% of patients, monocytosis in 40% of patients and neutrophilia in 10% of patients were found at peripheral blood. 2) Bone marrow findings: Lymphocytopenia in 30% of patients, lymphocytosis in 20% of patients, plasmacytosis in 40% of patients, monocytosis in 100% of patients, and hypocellularity in 30% of patients were found at bone marrow. Erythropoiesis was decreased in 30% of patients. Granulopoiesis was decreased in 20% of patients and increased in 20% of patients. Bone morrow granuloma occured in 25% of patients. Conclusion: Hematologic changes of miliary tuberculosis were seen tendency of cytopenic pattern but monocyte was increased at peripheral blood and bone morrow. This findings would provide additional information for the differential diagnosis of miliary tuberculosis.

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항암화학요법에 의하여 골수억제가 수반된 진행암 환자에서 Recombinant Human Granulocyte-Macrophage Colony Stimulating Factor(rhGM-CSF)의 용량과 효과에 관한 비교 연구

  • 노재경;라선영;이경희;이혜란;정현철;김주항;김병수
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.306-306
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    • 1994
  • 항암화학요법후 가장 심각한 부작용의 하나는 중성구 감소에 의한 감염이다. 본원에서는 rhGM-CSF을 이용한 제 I상 임상연구에서 150-500$\mu$g/M$^2$/day가 biologically active dose임을 보고한 바 있다. 연자들은 연세암센터에 내원하여 진행성 악성종양으로 병리조직학적 진단을 받고 항암화학요법시행후 골수억제가 예상되는 환자를 대상으로 GM-CSF 용량에 따른 안전성 및 독성을 검토하고 백혈구 감소증 및 감염의 예방, 치료효과를 분석하여 임상사용권장량을 결정하기위한 2상 연구를 대상환자의 동의를 얻은후 시행하였다. 대상환자는 37명 (여 26, 남 11)이었고, 항암제는 Adriamycin, Cisplatin, VP-16이 주로 사용되었다. 최적임상사용권장량을 결정하기 위하여 1500$\mu\textrm{g}$/M$^2$/day을 12명, 250$\mu\textrm{g}$/M$^2$/day을 12명, 350$\mu\textrm{g}$/M$^2$/day을 13명의 환자에게 투여하였다. 첫번째 항암 요법에는 rhGM-CSF을 투여하지않고 (비투여기) 두 번째 항암요법에서는 항암요법후 익일부터 10일간 연속, 매일 1회 피하주사하여 (투여기), rhGM-CSF 투여기와 비투여기의 백혈구 감소증 정도의 차이를 비교하였다.

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A Case of Neutropenia Induced by Short-Term Treatment of Vancomycin (반코마이신 단기간 투여로 유발된 호중구감소증 증례보고)

  • Kim, Su Hyun;Bang, Joon Seok;Kim, Kwang Joon;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.1
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    • pp.77-80
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    • 2013
  • 메치실린 저항성 황색 포도상구균(MRSA)에 감염된 환자에게 단기간 연속적으로 반코마이신을 투여했을 때 비정상적으로 호중구의 수치가 감소한 약인성 부작용 사례를 보고하고자 한다. 해당 여성 환자는 61세로서 MRSA 감염증을 판정받고 반코마이신 투여와 더불어 점차 백혈구(WBC)와 절대호중구수치(ANC)가 감소하였고, 제10일째에 이르러 호중구 감소증이 발생하여 ANC가 최저 430 $cells/mm^3$까지 낮아졌으나, 반코마이신의 투여를 중단하자 곧 정상수준으로 회복되었다. 본 사례는 Naranjo Probability Scale과 Korean Algorithm Score(Ver. 2.0)로 각각 평가하였을 때 반코마이신의 투여와 호중구감소증의 발현 사이에 모두 '가능한(probable)' 정도의 인과관계를 가진 것으로 평가되었다. 이는 통상적으로 20일 이상 연속투여를 할 때 임상적으로 관측되던 반코마이신-유래 호중구감소증이 단지 10일 정도의 단기간 투여만으로도 발생할 수 있다는 임상적 약물부작용의 사례로서, 향후 MRSA환자에게 반코마이신을 선택할 때에는 이와 같은 부작용을 고려하여 환자의 WBC와 ANC를 면밀히 관찰하면서 투여할 필요성이 있음을 시사한다.

Two Cases of Perforated Typhlitis in Acute Lymphocytic Leukemia (급성 림프구성 백혈병에 합병된 천공성 typhlitis)

  • Park, Woo-Hyun;Ahn, Keun-Soo;Choi, Soon-Ok
    • Advances in pediatric surgery
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    • v.7 no.1
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    • pp.59-63
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    • 2001
  • The authors, over the last 6 months, have treated 2 patients with perforated typhlitis complicating acute lymphocytic leukemia (ALL) with good outcome. The first patient was a 13-year-old male who developed intermittent high fever, abdominal pain, abdominal distention and diarrhea during the course of maintenance chemotherapy. The peripheral leukocyte ranged from 230-470/$mm^3$. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal and ascending colonic walls and subsequent ragged perforation of the posterior wall of the cecum. He survived after treatment by right hemicolectomy and aggressive supportive measures. The patient case was a 3 year-old female who developed intermittent high fever, right lower abdominal pain, a mass, and watery diarrhea during the course of maintenance chemotherapy. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal wall (6-15mm in thickness) and subsequent small perforation of the posterior wall of the cecum with thick-walled localized abscess. She has recovered completely after aggressive medical management. We learned two lessons from our experience treating these patients:1) early diagnosis provided by a high index of suspicion and the use of ultra sonogram or CT scan is essential. And 2) although perforation is one of the surgical indications for the treatment of typhlitis, it is possible to manage the perforation nonoperatively in selected cases with localized abscess.

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