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A Case of Immune Thrombocytopenic Purpura Associated with Scrub Typhus
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±èÇö¾Æ(Kim Hyun-Ah) - °è¸í´ëÇб³ ÀÇ°ú´ëÇÐ °¨¿°³»°úÇб³½Ç
ÀÌÁö¿¬(Lee Ji-Yeon) - °è¸í´ëÇб³ ÀÇ°ú´ëÇÐ °¨¿°³»°úÇб³½Ç
Çö¹Ì¸®(Hyun Mi-Ri) - °è¸í´ëÇб³ ÀÇ°ú´ëÇÐ °¨¿°³»°úÇб³½Ç
·ù¼º·Ä(Ryu Seong-Yeol) - °è¸í´ëÇб³ ÀÇ°ú´ëÇÐ °¨¿°³»°úÇб³½Ç
Abstract
ÂêÂê°¡¹«½Ãº´¿¡¼ Ç÷¼ÒÆÇ °¨¼ÒÁõÀº ÈçÈ÷ ³ªÅ¸³ª´Â Ç÷¾×ÇÐÀû ÀÌ»ó ¼Ò°ßÀÌ¸ç ±Þ¼º ¸é¿ª¼º Ç÷¼ÒÆÇ °¨¼Ò¼º ÀÚ¹ÝÁõÀº
´ëºÎºÐ ¹ÙÀÌ·¯½º °¨¿°Áõ°ú ¿¬°üµÇ¾î ÀÖ´Â °ÍÀ¸·Î ¾Ë·ÁÁ® ÀÖ´Ù. ÀúÀÚµéÀº ÂêÂê°¡¹«½Ãº´ ȯÀÚ¿¡°Ô¼ Áö¼ÓµÇ´Â Ç÷¼ÒÆÇ °¨¼ÒÁõÀ» ¸é¿ª¼º Ç÷¼ÒÆÇ °¨¼Ò¼º ÀÚ¹ÝÁõÀ¸·Î ÆÇ´ÜÇÏ°í ½ºÅ×·ÎÀÌµå »ç¿ë ÈÄ È£ÀüµÈ 1¿¹¸¦ °æÇèÇÏ¿´±â¿¡ À̸¦ º¸°íÇÏ´Â ¹ÙÀÌ´Ù.
Thrombocytopenia is a common manifestation of rickettsial disease. However, the pathogenesis of thrombocytopenia in many rickettsial diseases is poorly understood. Thrombocytopenia may be associated with consumption due to widespread endothelial damage or disseminated intravascular coagulation, hypersplenism, decreased marrow production, and immune-mediated platelet destruction. Some reports have found anti-platelet antibodies detected in thrombocytopenic patients with rickettsial disease. In addition to thrombocytopenia, facial palsy and Guillain-Barre syndrome were also reported as immune-mediated phenomena in scrub typhus. Here we report a case diagnosed as immune-mediated thrombocytopenia associated with scrub typhus. This is the first report of immune thrombocytopenic purpura (ITP) associated with scrub typhus in Korea. The patient exhibited eschar with a high titer of anti-tsutsugamushi antibody, thrombocytopenia, severe gastrointestinal hemorrhage, and purpura on the lower region of both legs. After steroid treatment, the sustained thrombocytopenia recovered.
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ÂêÂê°¡¹«½Ãº´, ¸é¿ª¼º Ç÷¼ÒÆÇ°¨¼Ò¼º ÀÚ¹ÝÁõ, À§Àå°üÃâÇ÷
Scrub typhus, Autoimmune thrombocytopenia, Gastrointestinal hemorrhage
KMID :
0882420140860030362
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