Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
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Volume 44, Issue 1
Displaying 1-8 of 8 articles from this issue
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  • A long-lasting idiopathic factor V inhibitor
    Yasushi OKOSHI, Hideki AKIYAMA, Takashi INOUE, Takatoshi KOYAMA, Natsu ...
    2003 Volume 44 Issue 1 Pages 14-18
    Published: 2003
    Released on J-STAGE: July 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.44.14
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    A rare case of a long-standing idiopathic acquired blood coagulation factor V (FV) inhibitor is reported. A 78 year-old -male was admitted complaining of hematuria and tarry stools of two weeks' duration. He was noted to have a prolonged prothrombin time and activated partial thromboplastin time. A mixing study suggested the existence of an inhibitor and the activity of FV was less than 1%. Western blot analysis revealed the presence of anti-FV antibodies in the patient's serum. Because of significant bleeding tendencies, the patient received fresh-frozen plasma, platelet transfusions and methylprednisolone. His PT, APTT and FV activity were partially corrected although the disease was exacerbated when the steroid dose was tapered off. The patient was then treated with low dose cyclophosphamide. The majority of the cases with acquired FV inhibitor occur spontaneously in older patients but this condition may be associated with a surgical procedure, administration of antibiotics, tuberculosis or malignant diseases; some of them are, however, idiopathic. No underlying disease was detected in our present patient. The inhibitor disappears within 10 weeks in most patients and the prolonged presence of an idiopathic FV inhibitor is rare.
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  • Simultaneous occurrence of acute myeloid leukemia with multilineage dysplasia and multiple myeloma
    Mamiko YANAGIMOTO, Kensuke USUKI, Kimiko IIJIMA, Yuji HIRAI, Seiko IKI ...
    2003 Volume 44 Issue 1 Pages 19-24
    Published: 2003
    Released on J-STAGE: July 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.44.19
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    An 82-year-old woman was admitted to our hospital because of dizziness and petechiae. Peripheral blood examination showed severe anemia and thrombocytopenia. Bone marrow aspiration revealed 42% leukemic blasts positive for peroxidase with multilineage dysplasia, leading to a diagnosis of acute myeloid leukemia with multilineage dysplasia. The levels of the patient's marrow plasma cells increased to 12%, whereas serum levels of IgG, A, and M dropped. λtype Bence Jones protein was detected on urine immunoelectrophoresis. The total urinary protein was 3,960mg/day. Bone scintigraphy detected multifocal uptake in the ribs. The diagnosis was multiple myeloma developing simultaneously with acute myeloid leukemia. Possible mechanisms for the occurrence of acute myeloid leukemia and multiple myeloma were discussed.
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  • Lymphoblastic lymphoma presenting as a solitary subcutaneous mass
    Mio KOJIMA, Naoto TOMITA, Katsumichi FUJIMAKI, Shin FUJISAWA, Heiwa KA ...
    2003 Volume 44 Issue 1 Pages 25-27
    Published: 2003
    Released on J-STAGE: July 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.44.25
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    A solitary cutaneous or subcutaneous mass in lymphoblastic lymphoma (LBL) is a rare manifestation. A 15-year-old girl presented with a subcutaneous LBL on her left back. There were no other lesions. Complete remission (CR) was achieved after 2 courses of ACOMP-B (doxorubicin, cyclophosphamide, vincristine, methotrexate, prednisolone, and bleomycin) therapy. Two courses of the chemotherapy and 4 sessions of prophylactic intrathecal methotrexate (15 mg/body) and hydrocortisone (25 mg/body) were added after CR. However, the patient relapsed with bone marrow involvement after 14 months remission. It is necessary to accumulate more experience with this kind of case to find the appropriate treatment strategy for solitary cutaneous or subcutaneous LBL.
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  • Clinical significance of anti-phosphatidylserine-prothrombin complex antibodies in the diagnosis of anti-phospholipid syndrome
    Junichi KABURAKI, Masataka KUWANA, Yasuo IKEDA
    2003 Volume 44 Issue 1 Pages 28-30
    Published: 2003
    Released on J-STAGE: July 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.44.28
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    In this study, we clarified the clinical significance of IgG anti-phosphatidylserine-prothrombin complex (PS-PT) antibodies in the diagnosis of antiphospholipid syndrome (APS). The study population consisted of 113 patients with SLE and lupus-like disease. IgG anti-PS-PT antibodies were examined by ELISA. These antibodies were detected in 31% of the population, and were significantly associated with thrombosis and fetal loss. The frequency was significantly higher in patients who did not satisfy the Sapporo criteria, but met the Harris and Hughes diagnostic criteria (36%) than in non-APS patients (14%). The above findings suggest that IgG anti-PS-PT antibodies should be listed in the diagnostic criteria for APS.
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  • Idiopathic thrombocytopenic purpura associated with mantle cell lymphoma showing an increase in the platelet count receiving anti-CD20 antibody rituximab
    Yasunori KAWACHI, Makoto IDE, Tatsumi UCHIDA, Kojun SETSU
    2003 Volume 44 Issue 1 Pages 31-33
    Published: 2003
    Released on J-STAGE: July 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.44.31
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    A 68-year-old man was admitted for bleeding tendency and generalized lymphadenopathy. A diagnosis of idiopathic thrombocytopenic purpura (ITP) associated with mantle cell lymphoma was made. The anti-CD20 monoclonal antibody rituximab 375mg/m2 was given intravenously once weekly for four consecutive weeks. The patient's platelet counts increased gradually from 0.6×104/μl to 5.8×104/μl. At eighteen weeks after discontinuation of rituximab medication, his platelet count increased again to 10.3×104/μl and this value has been sustained up to the time of writing. This suggests that rituximab is useful in the treatment of ITP associated with malignant lymphoma.
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