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혈구포식림프조직구증 환자에서의 치료적 혈장교환술 시행 증례보고

Other Titles
 Therapeutic Plasma Exchange in a Patient with Hemophagocytic Lymphohistiocytosis 
 노주혜  ;  김신영  ;  나현진  ;  이경애  ;  김현옥 
 Laboratory Medicine Online, Vol.9(4) : 249-253, 2019 
Journal Title
 Laboratory Medicine Online 
Issue Date
Hemophagocytic lymphohistiocytosis ; Therapeutic plasma exchange ; Thrombotic microangiopathy
A 22-year old female patient with systemic lupus erythematosus presenting microangiopathic hemolytic anemia was treated with therapeutic plasma exchange 23 times. The patient’s condition and laboratory findings (aspartate aminotransferase, alanine aminotransferase, ferritin, total bilirubin, and lactate dehydrogenase) did not improve despite the initial 18 therapeutic plasma exchange treatments. Thrombotic thrombocytopenic purpura was ruled out due to normal ADAMTS-13 activity test result; hemophagocytic lymphohistiocytosis was diagnosed based on fever, splenomegaly, pancytopenia, hypertriglyceridemia, hyperferritinemia, and hemophagocytosis in bone marrow aspiration. The patient’s condition improved rapidly upon treatment with a combination of immunosuppressants and cytotoxic agents, and more therapeutic plasma exchanges were performed five consecutive times with prolonged intervals in between. We observed that therapeutic plasma exchange treatment alone was not effective enough to treat hemophagocytic lymphohistiocytosis, unlike thrombotic thrombocytopenic purpura. Therefore, it is necessary to determine and start drug administration promptly in the treatment of hemophagocytic lymphohistiocytosis with thrombotic microangiopathy.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sin Young(김신영) ORCID logo https://orcid.org/0000-0002-2609-8945
Kim, Hyun Ok(김현옥) ORCID logo https://orcid.org/0000-0002-4964-1963
Roh, Juhye(노주혜)
Lee, Kyong Ae(이경애)
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