東京女子医科大学雑誌
Online ISSN : 2432-6178
Print ISSN : 0040-9022
ISSN-L : 0040-9022
88 巻, 4 号
選択された号の論文の4件中1~4を表示しています
目次
原著
  • 南雲 薫子, 平澤 恭子, 石黒 久美子, 衛藤 薫, 立川 恵美子, 永田 智
    2018 年 88 巻 4 号 p. 99-103
    発行日: 2018/08/25
    公開日: 2018/08/24
    ジャーナル フリー

    Propranolol was introduced as a treatment for infantile hemangiomas (IH). We report a summary of 13 cases of IH treated with propranolol and discuss its effectiveness. In our series, propranolol therapy was initiated at the mean age of 4.1 months (1-8 months), and the mean therapy duration was 15 months (9-20 months). All patients showed good clinical response. Only one patient experienced asymptomatic hypoglycemia as the side effect of the drug. To avoid the side effect, the dose was increased slowly, with a feeding interval of 3 or 4 hours. Under these conditions, hypoglycemia did not recur, which enabled treatment continuation. Propranolol conferred a risk of bronchial constriction that lead to wheezy bronchitis. One patient had wheezy respiration when he contracted a viral infection, during which time he stopped taking propranolol and resumed the treatment after 1 week. She showed no deterioration of bronchial symptoms and could complete the therapy.

    Adverse events such as hypoglycemia or low blood pressure might lead to a serious condition; thus, during therapy initiation, hospitalization and careful monitoring are needed. During home care after the initial hospitalization, frequent feeding and careful observation should be recommended with the medical staff's advice. With these considerations about adverse effects, propranolol therapy seems safe, effective, and easy, and should be the first-line therapeutic option.

報告
  • 浅野 千尋, 兒玉 聖子, 増田 道彦
    2018 年 88 巻 4 号 p. 104-107
    発行日: 2018/08/25
    公開日: 2018/08/24
    ジャーナル フリー

    Bone marrow lymphoma is a rare disease. Herein, we report a case of a 77-year old woman who was diagnosed with primary bone marrow lymphoma. She presented with fatigue and dyspnea 1 month before hospitalization. Two weeks before hospitalization, she underwent blood tests, and her complete blood count revealed pancytopenia. A bone marrow biopsy was performed and showed abnormal and diffuse lymphoid cells. On immunohistochemistry, these cells were positive for leukocyto common antigen (LCA), CD20, and Bcl-2. Upon further examination, there was no palpable lymphadenopathy. A positron emission/computed tomography (PET/CT) scan revealed fluorodeoxyglucose (FDG) uptake only by the vertebra and pelvic bone. The patient received R-T-COP chemotherapy (rituximab, cyclophosphamide, pirarubicin, vincristine, and prednisolone). Despite chemotherapy, the disease became refractory, and the patient died 3 months after chemotherapy. Based on this case, we recommend for pancytopenia to be considered a symptom of bone marrow lymphoma.

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