Pancytopaenia is a rare clinical presentation of severe leptospirosis. We would like to report a case of severe leptospirosis that progressed to pancytopaenia despite initial penicillin therapy. The patient needed a second course of antibiotic with doxycycline to improve his persistent symptoms and cytopaenia. Persistent pancytopaenia in severe leptospirosis and its management were reviewed.
Doxycycline/administration & dosage ; Drug Therapy, Combination ; Leptospirosis/*complications ; Leptospirosis/drug therapy ; Pancytopenia/drug therapy ; Pancytopenia/*etiology ; Penicillins/administration & dosage

Gastric cancer is a major cause of cancer-related mortality. At the time of diagnosis, majority of the patients usually have unresectable or metastatic disease. The most common sites of metastases are the liver and the peritoneum, but in the advanced stages, there may be metastases to any region of the body. Bone marrow is an important metastatic site for solid tumors, and the prognosis in such cases is poor. In gastric cancer cases, bone marrow metastasis is usually observed in younger patients and in those with poorly differentiated tumors. Prognosis is worsened owing to the poor histomorphology as well as the occurrence of pancytopenia. The effect of standard chemotherapy is unknown, as survival is limited to a few weeks. This report aimed to evaluate 5 gastric cancer patients with bone marrow metastases to emphasize the importance of this condition.
Bone Marrow* ; Diagnosis ; Drug Therapy ; Humans ; Liver ; Mortality ; Neoplasm Metastasis* ; Pancytopenia ; Peritoneum ; Prognosis ; Stomach Neoplasms

The cutaneous manifestations of hemophagocytic lymphohistiocytosis (HLH) are variable and nonspecific. A 42-year-old man presented with multiple annular, erythematous patches on the trunk for 3 months. Two months later, he presented with bullae along with high fever. The laboratory examination showed pancytopenia, hypertriglyceridemia, and hypofibrinogenemia. The bone marrow biopsy specimen showed an active hemophagocytosis. On the basis of these findings, a diagnosis of HLH was concluded. After five cycles of chemotherapy, his skin lesion completely resolved. Taking the results together, we suggest that annular skin lesion can be added to the list of cutaneous manifestations of HLH.
Adult ; Biopsy ; Bone Marrow ; Diagnosis ; Drug Therapy ; Fever ; Humans ; Hypertriglyceridemia ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Skin*

The cutaneous manifestations of hemophagocytic lymphohistiocytosis (HLH) are variable and nonspecific. A 42-year-old man presented with multiple annular, erythematous patches on the trunk for 3 months. Two months later, he presented with bullae along with high fever. The laboratory examination showed pancytopenia, hypertriglyceridemia, and hypofibrinogenemia. The bone marrow biopsy specimen showed an active hemophagocytosis. On the basis of these findings, a diagnosis of HLH was concluded. After five cycles of chemotherapy, his skin lesion completely resolved. Taking the results together, we suggest that annular skin lesion can be added to the list of cutaneous manifestations of HLH.
Adult ; Biopsy ; Bone Marrow ; Diagnosis ; Drug Therapy ; Fever ; Humans ; Hypertriglyceridemia ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Skin*

Trichosporon beigelii belongs to the family of Cryptococcaceae. T. beigelii is a rare causative agent of invasive pneumonia in immunocompromised patients. T. beigelii pneumonia is characterized by persistent fever unresponsive to broad-spectrum antibiotic the- rapy, coughing with bloody sputum, and rapidly progressive dyspnea. Its diagnosis should be based on clinical suspicion and confirmed by culture and histologic examination of biopsy tissue. We describe an ALL patient with T. beigelii pneumonia developed during severe pancytopenic period after salvage chemotherapy.
Biopsy ; Cough ; Diagnosis ; Drug Therapy* ; Dyspnea ; Fever ; Humans ; Immunocompromised Host ; Pancytopenia ; Pneumonia* ; Sputum ; Trichosporon*

Macrophage activation syndrome (MAS) is one of the serious complications of juvenile rheumatoid arthritis (JRA) and recently, cyclosporine A has been found to be effective in patients with corticosteroid-resistant MAS. A 29-yr-old male was admitted with high fever and jaundice for one month. He was diagnosed as juvenile arthritis 16 yr ago. Physical and laboratory results showed hepatosplenomegaly, high fever, pancytopenia and impaired liver and renal function tests, elevated triglyceride and serum ferritin levels. Bone marrow biopsy showed hyperplasia of histiocytes with active hemophagocytosis. He was diagnosed as MAS associated with juvenile rheumatoid arthritis and managed with high-dose corticosteroids initially, but clinical symptoms and laboratory findings did not improve immediately. Finally, he completely recovered after treatment with cyclosporine A (3 mg/kg/day).
Treatment Outcome ; Pancytopenia/*drug therapy ; Male ; *Macrophage Activation ; Lymphatic Diseases/*drug therapy ; Immunosuppressive Agents/therapeutic use ; Humans ; Cyclosporine/*therapeutic use ; Arthritis, Juvenile Rheumatoid/*drug therapy ; Adult

Lymphomatoid granulomatosis (LG) is an angiocentric lymphoproliferative disease. It usually involves lung, skin, and central nervous system, but splenomegaly and pancytopenia are the rare manifestations of the disease. We report a 15-year-old boy presented with fever, dry cough and dyspnea from two months ago, after admission patient had nodular lesions on the left leg and hepatosplenomegaly. Then he manifested neurologic signs such as seizure, aphasia and right-sided hemiplegia. Chest X-ray and CT scan revealed bilateral pulmonary nodules predominantly in lower lobes and peripheral lung fields. Laboratory exams showed pancytopenia. Skin biopsy was done, and histopathological examination and immunohistochemistry evaluation confirmed lymphomatoid granulomatosis. He was treated with steroid and cyclophosphamide but succumbed by neurologic involvement.
Adolescent ; Humans ; Lymphomatoid Granulomatosis ; diagnosis ; diagnostic imaging ; drug therapy ; Male ; Pancytopenia ; diagnosis ; diagnostic imaging ; drug therapy ; Radiography ; Splenomegaly ; diagnosis ; diagnostic imaging ; drug therapy

Glossopharyngeal neuralgia (GPN) is a rare condition characterized by paroxysms of lancinating pain in the regions of the tonsil, ear, larynx and tongue. The pain is typically triggered by activities such as swallowing, speaking or coughing. Fifty-seven years old female patient had suffered paroxysms of severe pain in the unilateral region of the glossopharyngeal innervation for several years, and long term drug therapy result in serious pancytopenia probably due to carbamazepine. The patient with idiopathic glossopharyngeal neuralgia received glossopharyngeal nerve block and her symptoms were relieved completely. Glossopharyngeal nerve block with alcohol was done by extraoral approach and satisfactory results were obtained.
Carbamazepine ; Cough ; Deglutition ; Drug Therapy ; Ear ; Female ; Glossopharyngeal Nerve Diseases* ; Glossopharyngeal Nerve* ; Humans ; Larynx ; Palatine Tonsil ; Pancytopenia ; Tongue

BACKGROUND: Lung cancer is the most common cause of cancer-related death worldwide and in Korea, and small cell lung cancer (SCLC) is the most deadly tumor type in the different lung cancer histology. Chemotherapy is the main strategy of the treatment for SCLC, and etoposide and platinum regimen has been the only standard chemotherapy for about 30 years. To test feasibility of weekly divided dose irinotecan and carboplatin for Korean patients is the aim of this study. METHODS: Patients with histologically or cytologically confirmed extensive stage SCLC were included. Patients with limited stage (LD), who could not tolerate concurrent chemoradiotherapy were also included. All the patients received irinotecan 60 mg/m2, carboplatin 2 area under the curve at day 1, 8, and 15 every 4 weeks. Study regimen was discontinued when the disease progressed or intolerable side effects occurred. No more than 6 cycles of chemotherapy were given. RESULTS: Total 47 patients were enrolled, among them 9 patients were LD. Overall response rate was 74.5% (complete response, 14.9%; partial response, 59.6%). Side effects greater than grade 3 were neutropenia (25.5%), fatigue (12.8%), thrombocytopenia (8.5%), sepsis (4.3%), and pancytopenia (2.1%). There was no treatment related death. CONCLUSION: Weekly divided irinotecan and carboplatin regimen is effective, and safe as a first line therapy for both stage of SCLC. Large scaled, controlled study is feasible.
Carboplatin* ; Chemoradiotherapy ; Cisplatin ; Drug Therapy ; Etoposide ; Fatigue ; Humans ; Korea ; Lung Neoplasms ; Neutropenia ; Pancytopenia ; Platinum ; Sepsis ; Small Cell Lung Carcinoma* ; Thrombocytopenia

We report a case of systemic diffuse large B-cell lymphoma presenting with extensive infiltration of the skin. A 56-year-old woman presented with a two-month history of pruritic erythematous plaques and nodules over the neck, trunk and upper limbs. She also had night sweats, weight loss, lethargy and reduced effort tolerance. Systemic examination revealed a pale, ill appearance with hepatosplenomegaly and lymphadenopathy. Blood investigations showed pancytopenia (haemoglobin 6.3 g/dL, total white cell count 3.0 × 10(9)/L, platelet count 138 × 10(9)/L) with a few suspicious mononuclear cells and a mildly elevated lactate dehydrogenase level (478 U/L). Skin biopsy demonstrated diffuse sheets and nodular infiltrates of CD20 and CD79a positive neoplastic cells in the dermis and subcutis. Computed tomography revealed multiple cervical, axillary, mediastinal, para-aortic and mesenteric lymph nodes. Bone marrow aspiration and trephine biopsy confirmed marrow involvement by non-Hodgkin's lymphoma. The patient was treated with chemotherapy, which resulted in resolution of the skin lesions.
Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; complications ; drug therapy ; pathology ; Middle Aged ; Pancytopenia ; etiology ; Pruritus ; etiology ; Skin Neoplasms ; complications ; drug therapy ; pathology ; secondary