• Title/Summary/Keyword: Hematologic diseases

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A Case of Thrombocytopenia and Purpura Induced by Rifampin, Pyrazinamide, and Ciprofloxacin (Rifampin, Pyrazinamide and Ciprofloxacin에 의한 혈소판 감소증, 자반증 1예)

  • Son, Hyung-Dae;Kim, Chang-Sun;Park, Mi-Ran;Seo, Ji-Yung;Rheu, Nam-Soo;Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.930-934
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    • 1997
  • Drug-induced thrombocytopenia and purpura have been developed by many various agents. Rifampin and Pyrazinamide have been known as bactericidal antituberculous drugs, but, the above side effects have been a problem. Especially, hematologic side effects are fatal to patients occasionally. Rifampin-induced thrombocytopenia and purpura have been well known, also, pyrazinamide-induced thrombocytopenia have been reported. A new quilonone agent, Ciprofloxacin, has been commonly used in clinics now, but it's side effects are not known well. So, we report a case of a 23-year-old female with thrombocytopenia and purpura after taking Rifampin, Pyrazinamide, and Ciprofloxacin as antituberculous agents.

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A Case of the Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) Following Isoniazid Treatment

  • Lee, Jin-Yong;Seol, Yun-Jae;Shin, Dong-Woo;Kim, Dae-Young;Chun, Hong-Woo;Kim, Bo-Young;Jeong, Shin-Ok;Lim, Sang-Hyok;Jang, An-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.1
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    • pp.27-30
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    • 2015
  • The drug reaction with eosinophilia and systemic symptom (DRESS) syndrome is a severe adverse drug-induced reaction which includes a severe skin eruption, fever, hematologic abnormalities (eosinophilia or atypical lymphocytes) and internal organ involvement. The most frequently reported drug was anticonvulsants. The diagnosis of DRESS syndrome is challenging because the pattern of cutaneous eruption and the types of organs involved are various. The treatments for DRESS syndrome are culprit drug withdrawal and corticosteroids. Here we report a 71-year-old man with skin eruption with eosinophilia and hepatic and renal involvement that appeared 4 weeks after he had taken anti-tuberculosis drugs (isoniazid, ethambutol, rifampicin, and pyrazinamide), and resolved after stopping anti-tuberculosis drugs and the administration of systemic corticosteroids. DRESS recurred after re-challenging isoniazid, we identified isoniazid was causative drug.

A Case of Acute Interstitial Pneumonia with Invasive Pulmonary Aspergillosis (침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴 1예)

  • Lee, Young-Min;Yoon, Hye-Kyoung;Kim, Joo-In
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.62-69
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    • 2002
  • Acute interstitial pneumonia (AIP) is a rare fulminant form of lung injury that presents acutely; usually in a previously healthy individual. It corresponds to a subset of cases of idiopathic adult respiratory distress syndrome (ARDS). Invasive pulmonary aspergillosis is a disease occuring predominantly with defects in immunity such as hematologic malignancy, influenza infection, postchemotherapy, long-term corticosteroid treatment. Invasive aspergillosis has worse prognosis and most cases are diagnosed at postmortem autopsies. We experienced a case of acute interstitial pneumonia with an invasive aspergillosis during corticosteroid treatment. Acute interstitial pneumonia with invasive aspergillosis was diagnosed by an open lung biopsy using thoracoscopy, showing fungal hyphae with sepsis and an acute angle branching invasion of the lung tissue and blood vessels. The patient was treated with IV amphotericin-B, but died due to septic shock.

Analysis of Risk and Benefit of Open Lung Biopsy in Severe Immunocompromised Patients with Pulmonary Complications (폐합병증을 동반한 심한 면역저하 환자에서 폐생검술의 유효성 및 위험성에 대한 분석)

  • 이호석;이성호;김관민;심영목;한정호
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.539-546
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    • 2001
  • Background: Pulmonary complications in immunocompromised patients are often fatal. Empirical treatment is usually applied based on the clinical and radiological findings because of the risk of the aggressive diagnostic procedures such as open lung biopsy. However, recent advancements in operative procedures and perioperative management has decreased the procedure-related risks. We have prospectively analyzed the risks and benefits of the early application of open lung biopsy in such patients. Material and Method: Forty-two consecutive immunocompromised patients with critical pulmonary complications were included from June, 1996 to December, 1999. The definition of the immunocompromised is as those with chemotherapy and/or other modality for hematologic disorders, with usage of immunosuppressive drug after transplantation, with usage of steroid for more than 1 month, and with primary immunodeficiency disorders. The indication of open lung biopsy was those with no significant improvement after a week of aggressive application of empirical treatment or with rapidly aggressive process. The underlying disease included hematologic disorder(31 patients), post-transplantation(3 patients), chemotherapy for solid tumor(2 patients), and others(6 patients). Operations were done through thoracotomy(conventional or mini-) or VATS.

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Electrophysiological features and prognosis of peripheral neuropathy associated with IgM monoclonal gammopathy: a single-center analysis in South Korea

  • Sooyoung Kim;Bit Na Lee;Seung Woo Kim;Ha Young Shin
    • Annals of Clinical Neurophysiology
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    • v.25 no.2
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    • pp.84-92
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    • 2023
  • Background: Clinical spectrum of immunoglobulin M (IgM) monoclonal gammopathy varies from IgM monoclonal gammopathy of unknown significance (IgM-MGUS) to hematological malignancies. We evaluated the clinical features, electrophysiological characteristics, and prognosis of patients with peripheral neuropathy associated with IgM monoclonal gammopathy (PN-IgM MG). Methods: We retrospectively evaluated 25 patients with PN-IgM MG. Peripheral neuropathy was classified as axonal, demyelinating, or undetermined, based on electrophysiological studies. We classified the enrolled patients into the IgM-MGUS and malignancy groups, and compared the clinical and electrophysiological features between the groups. Results: Fifteen patients had IgM-MGUS and 10 had hematologic malignancies (Waldenström's macroglobulinemia: two and B-cell non-Hodgkin's lymphoma: eight). In the electrophysiological evaluation, the nerve conduction study (NCS) criteria for demyelination were met in 86.7% of the IgM-MGUS group and 10.0% of the malignancy group. In particular, the distal latencies of the motor NCS in the IgM-MGUS group were significantly prolonged compared to those in the malignancy group (median, 9.1 ± 5.1 [IgM-MGUS], 4.2 ± 1.3 [malignancy], p = 0.003; ulnar, 5.4 ± 1.9 [IgM-MGUS], 2.9 ± 0.9 [malignancy], p = 0.001; fibular, 9.3 ± 5.1 [IgM-MGUS], 3.8 ± 0.3 [malignancy], p = 0.01; P-posterior tibial, 8.3 ± 5.4 [IgM-MGUS], 4.4 ± 1.0 [malignancy], p = 0.04). Overall treatment responses were significantly worse in the malignancy group than in the IgM-MGUS group (p = 0.004), and the modified Rankin Scale score at the last visit was higher in the malignancy group than in the IgM-MGUS group (2.0 ± 1.1 [IgM-MGUS], 4.2 ± 1.7 [malignancy], p = 0.001), although there was no significant difference at the initial assessment. Conclusions: The risk of hematological malignancy should be carefully assessed in patients with PN-IgM MG without electrophysiological demyelination features.

Gelatinous Transformation of Bone Marrow Mimicking Malignant Marrow-Replacing Lesion on Magnetic Resonance Imaging in a Patient without Underlying Devastating Disease

  • Lee, Joohee;Yoo, Yeon Hwa;Lee, Sarah;Kim, Hak Sun;Kim, Sungjun
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.1
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    • pp.50-55
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    • 2018
  • Gelatinous transformation of bone marrow is characterized by hypoplasia of fat cells with focal loss of hematopoietic cells and deposition of extracellular gelatinous substances. It is known to be associated with devastating underlying diseases that starve bone marrow. Here, we present a case of a patient whose magnetic resonance (MR) imaging findings of vertebral column were interpreted as metastasis or hematologic malignancy, however, the final diagnosis revealed a gelatinous transformation of bone marrow. This is the first report of gelatinous transformation of bone marrow without evidence of underlying devastating disease.

Large Vessel Vasculitis as an Initial Manifestation of Acute Myeloid Leukemia: A Case Report (대혈관 혈관염이 첫 번째 징후로 나타난 급성 골수성 백혈병: 증례 보고)

  • Gayoung Jeon;Dongjin Yang;Jongchang Jang; Jongwan Kang
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.918-923
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    • 2022
  • Large vessel vasculitis is characterized by chronic inflammation within the aortic wall and its major branches. The inflammation is considered to occur as a result of immune dysregulation. Hematologic malignancy is one of the rare causes of secondary vasculitis. Herein, we report a rare case of large vessel vasculitis associated with acute myeloid leukemia mimicking primary vasculitis.

A New Inflammatory Prognostic Index, Based on C-reactive Protein, the Neutrophil to Lymphocyte Ratio and Serum Albumin is Useful for Predicting Prognosis in Non-Small Cell Lung Cancer Cases

  • Dirican, Nigar;Dirican, Ahmet;Anar, Ceyda;Atalay, Sule;Ozturk, Onder;Bircan, Ahmet;Akkaya, Ahmet;Cakir, Munire
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5101-5106
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    • 2016
  • Purpose: We aimed to establish an inflammatory prognostic index (IPI) in early and advanced non-small cell lung cancer (NSCLC) patients based on hematologic and biochemical parameters and to analyze its predictive value for NSCLC survival. Materials and Methods: A retrospective review of 685 patients with early and advanced NSCLC diagnosed between 2009 and 2014 was conducted with collection of clinical, and laboratory data. The IPI was calculated as C-reactive protein ${\times}$ NLR (neutrophil/ lymphocyte ratio)/serum albumin. Univariate and multivariate analyses were performed to assess the prognostic value of relevant factors. Results: The optimal cut-off value of IPI for overall survival (OS) stratification was determined to be 15. Totals of 334 (48.8%) and 351 (51.2%) patients were assigned to high and low IPI groups, respectively. Compared with low IPI, high IPI was associated with older age, greater tumor size, high lymph node involvement, distant metastases, advanced stage and poor performance status. Median OS was worse in the high IPI group (low vs high, 8.0 vs 34.0 months; HR, 3.5; p<0.001). Progression free survival values of the patients who had high vs low IPI were determined 6 months (95% CI:5.3-6.6) and 14 months (95% CI:12.1-15.8), respectively (HR; 2.4, P<0.001). On multivariate analysis, stage, performance status, lactate dehydrogenase and IPI were independent prognostic factors for OS. Subgroup analysis showed IPI was generally a significant prognostic factor in all clinical variables. Conclusion: The described IPI may be an inexpensive, easily accessible and independent prognostic index for NSCLC patients, useful for clinical practice.

Investigation of diseases incident to pre- and pos-weaning piglets (포유 및 이유자돈의 질병발생 동향)

  • Oh, Myong-ho;Eun, Gil-soo;Kim, Hong-jib;Kyon, Young-bang
    • Korean Journal of Veterinary Research
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    • v.40 no.1
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    • pp.173-186
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    • 2000
  • This experiment was carried out to investigate the tendency of incident diseases in pre- and post- weaning piglets which ages were 1 to 7 weeks old by laboratory diagnosis and in order to minimize death in preweaning piglets and of stunted growth in postweaning piglets. The result of this experiment used as the basic data for the preventive programs in pre- and post- weaning piglets and were as follows: 23 different diseases diagnosed in 331 cases were studied in relation to age, season, and etiology. The most prevelent diseases of pre- and post- weaning piglet were Colibacillosis(79 case, 23.9%) and the major diseases were Salmonellosis(44 cases, 13.3%), Anemia(37 cases, 11.2%). Unknown viral disease(20 case, 6.1%), Rota viral infection(19 case, 5.8%), Porcine reproductive & respiratory syndrome(PRRS; 15 case 4.5%), Transmissible gastroenteritis(TGE; 12 case, 3.6%). The gastrointestinal disease, such as Colibacillosis, Salmonellosis, Swine dysentery, Clostridial infection, Rotaviral infection, TGE, Porcine epidemic diarrhea(PED) and Ballantidiosis occured pro- dominently in the period of pre- and post- weaning, which were 178 cases(53.8%) and not related to occurrence according to age and season. The respiratory diseases were Atrophic rhinitis(AR), Swine enzootic pneumonia, Pneumonic pasteurellosis, Pleuropneumonia, Branchopneumonia, PRRS and which were 48 cases(14.5%) and higher prevalent in spring and summer. The viral diseases was 73 cases(22.1%) that occurred in the period of 5 weeks piglet and prevalent mainly in spring. The bacterial diseases were 188 cases(56.8%) that were not related to occurrence according to age and season. Salmonellosis was prevalent in 3 to 5 weeks piglet and mainly occurred in summer. Viral septicemia and rotaviral infection occurred after 5 weeks piglets intensively and 3 to 5 weeks, respectively. And the both occurred without relation with season. PRRS occurred after 4 weeks piglet and prevalent in summer. TGE occurred 1 to 7 days old piglets and prevalent in spring and winter. Hematologic values of anemia was decrease in number of Red Blood Cell, concentration of Hemoglobin and Hematocrit. Amikacin, cephalothin, colistin, norfloxacin were effective to E coli, and amikacin, cephalothin, nortloxacin, neomycin were effective to Salmonellra spp. but clindamycin, erythromycin, penicillin, sulfonamides were resistant to E coli and Salmonella spp.

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Hematologic Complication of Respiratory Virus Infection (호흡기바이러스 감염에 의한 혈액학적 합병증)

  • Park, In Ho;Lee, Su Ho;You, Sung Taek;Choi, Du Young
    • Pediatric Infection and Vaccine
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    • v.20 no.3
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    • pp.178-185
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    • 2013
  • Objective: Cytopenia is a common hematologic complication of viral infections. However, information regarding hematologic effects of common respiratory virus infections is scarce. This study aimed to evaluate hematologic complications and the clinical course of patients infected with common respiratory viruses. Methods: We retrospectively analyzed 496 patients with respiratory tract infections admitted to the Department of Pediatrics, Wonkwang University Hospital from November 2011 to March 2012 using multiplex real-time polymerase chain reaction to detect the presence of respiratory viruses and hematologic abnormalities. Results: Respiratory viruses were identified in 379 patients. Respiratory syncytial virus (RSV) was most frequently detected (55.7%), followed by influenza A (Flu-A, 23.0%). Further, cytopenia was observed in 35.5% of RSV-infected patients, 25.0% of Flu-A-infected patients, and 34% of patients infected by other viruses. Each virus caused a decrease in 3 blood cell component values, which corresponded with cytopenia frequency. Of the 379 infected patients, 83 had anemia ($9.71{\pm}1.09g/dL$); 46 had neutropenia ($803.70{\pm}263.09cells/mm^3$); and 23 had transient thrombocytopenia ($142,434.78{\pm}86,835.18cells/mm^3$). However, no patient required treatment. A comparison of clinical characteristics between RSV- and Flu-A-positive patients with anemia revealed that RSV-infected patients had significantly longer duration of hospitalization. RSV was detected more commonly in young neutropenic patients, who had a shorter duration of fever. Conclusions: Our findings suggest that infections, particularly RSV and Flu-A, result in varying degrees of cytopenia, which usually improves without treatment and does not affect the clinical course of the infection.

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