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Volume 49, Issue 1
Displaying 1-10 of 10 articles from this issue
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Picture in Clinical Hematology No.23
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2008 Volume 49 Issue 1 Pages 1
Published: 2008
Released on J-STAGE: September 05, 2008
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Review
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Hideki MAKISHIMA2008 Volume 49 Issue 1 Pages 3-9
Published: 2008
Released on J-STAGE: September 05, 2008
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Kazuki TANIMOTO, Akihiro KANEKO, Shigenobu SUZUKI, Naohiro SEKIGUCHI, ...2008 Volume 49 Issue 1 Pages 10-17
Published: 2008
Released on J-STAGE: September 05, 2008
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Ritsuro SUZUKI2008 Volume 49 Issue 1 Pages 18-29
Published: 2008
Released on J-STAGE: September 05, 2008
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Case Reports
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Yasushi TERASAKI, Hirokazu OKUMURA, Yoshihisa ISHIURA, Shigeru YOKAWA, ...2008 Volume 49 Issue 1 Pages 30-34
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSA 64-year-old woman visited our hospital in December 2005 because of general malaise. Her hemoglobin level was 9.0 g/dl. Gastrointestinal fiberscopy detected a hemorrhagic gastric ulcer, which was considered as etiology of anemia. Abdominal ultrasonography showed bilateral hydronephroses and hydroureters. A urine test revealed pyuria and macroscopic hematuria, and urine culture revealed 108 colony-forming units of Escherichia coli per ml. Pelvic MRI showed thickening of the posterior wall and trigone of the urinary bladder. Transurethral resection was peformed, and biopsy of the mucous of the bladder gave a diagnosis of primary mucosa-associated lymphoid tissue (MALT) lymphoma of the urinary bladder. Ann Arbor clinical stage was IEA. It was planned to administer irradiation at a total dose of 36 Gy to the whole bladder and part of the tumor; however, radiotherapy was discontinued at a dose of 26 Gy because of the development of pollakisuria. Pelvic MRI and pathologic examination of the urinary bladder after radiotherapy showed that the lymphoma was in complete remission; however, she received retuximab therapy at a dose of 375 mg/m2/week, 8 times additionally, because of the reduced radiotherapy. The patient has remained in complete remission for 14 months.View full abstractDownload PDF (1033K) -
Takumi HOSHINO, Hirono IRIUCHIJIMA, Yoshiyuki OGAWA, Hiroyuki IRISAWA, ...2008 Volume 49 Issue 1 Pages 35-39
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSA 61-year-old woman presented with hepatosplenomegaly, systemic lymphadenopathy, anemia, and thrombocytopenia. Peripheral blood and bone marrow examination showed atypical lymphoid cells with villi. Immunophenotyping of these cells was CD19+ CD20+ CD5- CD10- CD23-, and light chain restriction (kappa) was positive. To confirm the diagnosis histologically, we performed a splenectomy and diagnosed the patient's disease as splenic marginal zone lymphoma (SMZL). She rapidly recovered normal hematological parameters and gallium-67 citrate scan showed no increased uptake. Two months after the splenectomy, however, she was readmitted with findings of 15% blasts in the peripheral blood and massive infiltration of the bone marrow by large blastoid cells. Laboratory evaluations were positive for monoclonal IgM-kappa protein. Under acute renal dysfunction, we performed a CT scan that showed bilateral enlargement of the kidneys with features suggestive of an infiltrative process besides systemic lymph node enlargement. A kidney biopsy established the diagnosis of lymphoma with renal infiltration. SMZL is characterized by an indolent clinical course, and no previous report has described SMZL with bilateral renal invasion. Complete remission was obtained after 3 cycles of chemothreapy (R-CHOP). She is undergoing 3 more courses and remains in remission 6 months after the rapid progress of her illness.View full abstractDownload PDF (570K) -
Yuho NAJIMA, Kazuteru OHASHI, Minoru ANDO, Akira KOSHIDA, Takuya YAMAS ...2008 Volume 49 Issue 1 Pages 40-45
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSA 51-year-old woman with myelodysplastic syndrome developed HHV-6 encephalitis on day 34 after unrelated bone marrow transplantation. Although prompt treatment with foscarnet stabilized encephalitis and there were no serious neurological sequelae, the patient developed both hyponatremia and natriuresis 11 days after intravenous administration of foscarnet. Subsequent investigation demonstrated hyponatremia due to salt-wasting nephropathy induced by foscarnet. Discontinuation of foscarnet and fluid replacement therapy with adequate sodium chloride (NaCl) resulted in a gradual resolution of hyponatremia and natriuresis. Currently, 8 months after these clinical events, the patient is under outpatient treatment for persistent nephropathy that requires small amounts of oral NaCl supplement, but she is otherwise in good clinical condition.View full abstractDownload PDF (627K) -
Postpartum hemorrhage successfully treated with recombinant factor VIIa in Glanzmann thromboastheniaSayaka SUGIHARA, Shinya KATSUTANI, Hideo HYODO, Maki HYODO, Yoshiki KU ...2008 Volume 49 Issue 1 Pages 46-50
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSGlanzmann thrombasthenia is an inherited hemorrhagic disorder characterized by severe reduction or absence of platelet aggregation in response to multiple physiologic agonists due to qualitative or quantitative abnormalities of platelet glycoprotein (GP) IIb/IIIa. Treatment of bleeding episodes may require platelet transfusion. However, repeated platelet transfusions may result in GPIIb/IIIa and/or HLA immunization, and development of platelet refractoriness. Recently, a number of reports have suggested that recombinant factor VIIa product (rFVIIa) may be a therapeutic alternative in these situations. We have used rFVIIa to treat a 34-year-old primigravida woman for postpartum bleeding. She had been diagnosed with Glanzmann thrombasthenia at 32 years of age. At 37 weeks gestation, she underwent elective caesarean section uneventfully with platelet transfusion. Nine days later, she developed vaginal bleeding and received twenty units of platelet concentrates every day, but bleeding persisted. Thereafter, 4.8 mg intravenous rFVIIa was administered three times, which immediately arrested the bleeding. These results demonstrate that rFVIIa is effective for severe bleeding in Glanzmann thrombasthenia patients, especially in those with antiplatelet antibodies and/or platelet transfusion refractoriness.View full abstractDownload PDF (395K)
Short Reports
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Atsuko FUJITA, Shin FUJISAWA, Rika OHSHIMA, Rie HYO, Hideyuki KUWABARA ...2008 Volume 49 Issue 1 Pages 51-54
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSA 42-year-old woman was admitted to our hospital with acute myelogenous leukemia. We conducted blood-type examination, and her serum showed strong agglutination with all B cells but questionable agglutination with A1 cells, which became stronger with incubation. We considered her blood type as O, but her previously assessed blood type was A. After receiving one cycle of induction therapy, she achieved complete remission and blood group A antigen was proven on her red blood cells. Anti-A1 in her serum disappeared after induction therapy. We should be aware that blood group antigens are not entirely independent of the environment and are occasionally modified by disease.View full abstractDownload PDF (133K) -
Shinichi KOBAYASHI, Fumihiko KIMURA, Kazuto OGURA, Ayako KOBAYASHI, Hi ...2008 Volume 49 Issue 1 Pages 55-58
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSPyomyositis is a purulent infection of skeletal muscle characterized by fever, localized muscle pain and stiffness, swelling and tenderness. Hematological disorder is one of the predisposing conditions for the development of pyomyositis. A 54-year-old man developed methicillin-resistant Staphylococcus aureus pyomyositis during drug-induced pancytopenia. Debridement of the infection foci combined with antimicrobial agents proved effective even in the advanced stage of the disease. In patients with hematological disorders, pyomyositis should be considered when evaluating local myalgia and high fever because this disease can be very difficult to identify and can become rapidly progressive under a myelosuppressive condition.View full abstractDownload PDF (1186K)
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