쯔쯔가무시병에 동반된 면역성 혈소판 감소증 1예
A Case of Immune Thrombocytopenic Purpura Associated with Scrub Typhus
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Thrombocytopenia is a common manifestation of rickettsial disease. However, the pathogenesis of thrombocytopenia in manyrickettsial diseases is poorly understood. Thrombocytopenia may be associated with consumption due to widespread endothelialdamage or disseminated intravascular coagulation, hypersplenism, decreased marrow production, and immune-mediated plateletdestruction. Some reports have found anti-platelet antibodies detected in thrombocytopenic patients with rickettsial disease. Inaddition to thrombocytopenia, facial palsy and Guillain-Barré syndrome were also reported as immune-mediated phenomena inscrub typhus. Here we report a case diagnosed as immune-mediated thrombocytopenia associated with scrub typhus. This is the firstreport of immune thrombocytopenic purpura (ITP) associated with scrub typhus in Korea. The patient exhibited eschar with a hightiter of anti-tsutsugamushi antibody, thrombocytopenia, severe gastrointestinal hemorrhage, and purpura on the lower region ofboth legs. After steroid treatment, the sustained thrombocytopenia recovered.
Abstract
Thrombocytopenia is a common manifestation of rickettsial disease. However, the pathogenesis of thrombocytopenia in manyrickettsial diseases is poorly understood. Thrombocytopenia may be associated with consumption due to widespread endothelialdamage or disseminated intravascular coagulation, hypersplenism, decreased marrow production, and immune-mediated plateletdestruction. Some reports have found anti-platelet antibodies detected in thrombocytopenic patients with rickettsial disease. Inaddition to thrombocytopenia, facial palsy and Guillain-Barré syndrome were also reported as immune-mediated phenomena inscrub typhus. Here we report a case diagnosed as immune-mediated thrombocytopenia associated with scrub typhus. This is the firstreport of immune thrombocytopenic purpura (ITP) associated with scrub typhus in Korea. The patient exhibited eschar with a hightiter of anti-tsutsugamushi antibody, thrombocytopenia, severe gastrointestinal hemorrhage, and purpura on the lower region ofboth legs. After steroid treatment, the sustained thrombocytopenia recovered.
참고문헌 (10)
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