In this study, we report the first clinically identified case of severe fever with thrombocytopenia syndrome (SFTS) in a 73-year old man from Jeju Island, South Korea. Although his initial manifestation suggested tsutsugamushi disease with cutaneous lesion, later the patient presented with symptoms characteristic of SFTS. Despite intensive medical therapies upon the clinical diagnosis of SFTS, patient's condition rapidly deteriorated. SFTS is a fatal disease that requires early diagnosis and appropriate supportive treatment.
Diagnosis ; Early Diagnosis ; Fever* ; Humans ; Korea ; Scrub Typhus ; Thrombocytopenia*

Immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia in children and can be defined as an autoimmune disorder of isolated thrombocytopenia without other causes of thrombocytopenia. This review will focus on the diagnostic approach of ITP, especially regarding the differential diagnosis. The practice of differential diagnosis has the goal of distinguishing primary ITP from secondary ITP and nonimmune thrombocytopenia requiring different treatments and showing different prognoses.
Child ; Diagnosis ; Diagnosis, Differential ; Humans ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic* ; Thrombocytopenia

China ; Clinical Protocols ; Hospital Units ; Humans ; Physicians ; Thrombocytopenia ; diagnosis ; therapy

Fever ; Humans ; Plasma Cells ; pathology ; Thrombocytopenia ; diagnosis ; pathology

Neonatal thrombocytopenia, defined as platelet counts of less than 150,000/µL, is a frequent hematologic abnormality in neonatal period. Differential diagnosis of neonatal thrombocytopenia may be challenging to pediatric hematologists and neonatologists because neonatal thrombocytopenia is associated with diverse maternal or neonatal clinical conditions. An accurate diagnosis for neonatal thrombocytopenia will lead to appropriate evaluation and management. Platelet transfusion is the primary management of neonatal thrombocytopenia. Most thrombocytopenic newborns received platelet concentrates to prevent major hemorrhage or treat ongoing bleeding according to institutional policy. However, scientific evidences for benefit and consistent guideline for platelet transfusion in neonates are lacking, further investigation to establish the standard recommendation for platelet transfusion is needed. This article reviewed the diagnostic approach and current guideline for platelet transfusion management for neonatal thrombocytopenia.
Blood Platelets ; Diagnosis ; Diagnosis, Differential ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Organizational Policy ; Platelet Count ; Platelet Transfusion ; Thrombocytopenia ; Thrombocytopenia, Neonatal Alloimmune

A clinical and laboratory study was conducted on 58 children who had been admitted to out pediatric department from February to September 1979, under the clinical diagnosis of septicemia. Following results were obtained: 1. Boys were affected more frequently than girls(1.3:1), and highest incidence was noticed in newborn period, comprising 50% of the total cases. 2. The common clinical manifestations, in order of frequency, were fever, lethargy, jandice, poor sucking and abdominal distension, and hyperbilirubionemia was the most common assocaited disease, followed by anemia and leukemia. 3. Clinical course revealed death in 6 patients(10.3%), discharge against advice in 7cases(21.1%) and complete recovery in the remaining 45 cases(77.6%). 4. Peripheral blood count showed leukocytosie in 40%, leukopenia in 12.1% and thrombocytopenia was seen in 45% of cases. 5. Gram staining of buffy coat smear showed bacteria in 34.5% and especially high ratio was noticed in newborn infants(48.3%). 6. Positive blood culture was seen in 39.7% with highest ratio of 45% in newborn infants. In positive blood culture group, toxic granules were noted in 32.8%, shift to left in 25.9%, hrombocytopenia in 18.9% and positive buffy coat smear in 15.5%. In summary, thrombocytopenia, toxic granules, shift to left were quite helpful in early diagnosis of sepsis. In addition to diagnostic value, examination of buffy coat smear could aid physician to select appropriate antibiotic regimen especially in sepsis of newborn period.
Anemia ; Bacteria ; Child* ; Diagnosis ; Early Diagnosis ; Fever ; Humans ; Incidence ; Infant, Newborn ; Lethargy ; Leukemia ; Leukopenia ; Sepsis* ; Thrombocytopenia

One 22-month-old boy who was admitted for a fever lasting 6 days as well as a cough and wheezing lasting 2 days was reported. He was diagnosed with influenza A (H1N1, severe type), severe pneumonia, acute respiratory distress syndrome (ARDS), Evans syndrome and multiple organ failure. This is the first case of novel influenza A (H1N1) and Evans syndrome. The pathogenesis is still unknown.
Anemia, Hemolytic, Autoimmune ; diagnosis ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype ; pathogenicity ; Influenza, Human ; diagnosis ; virology ; Male ; Thrombocytopenia ; diagnosis

Adult ; Diagnostic Tests, Routine ; Female ; Hearing Loss, Sensorineural ; Humans ; Pedigree ; Thrombocytopenia ; diagnosis ; genetics

Giant platelet syndrome is a group of unique disorders characterized by the presence of abnormally large platelets, and usually accompanied by thrombocytopenia. Most cases of giant platelets are encountered in idiopathic thrombocytopenic purpura(ITP). In contrast, inherited giant platelet disorders, a group of heterogeneous diseases, are rare. Bernard-Soulier syndrome and its variants, and MYH9 related diseases have been defined at the molecular level. Abnormalities in transcription factors are implicated in a couple of macrothrombocytopenia syndromes. However, the molecular defects are unknown in gray platelet syndrome. It is important to make a proper diagnosis of congenital macrothrombocytopenia to avoid unnecessary medications and potentially dangerous treatment for presumed ITP.
Bernard-Soulier Syndrome* ; Blood Platelets ; Diagnosis ; Gray Platelet Syndrome ; Thrombocytopenia ; Transcription Factors

BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a significant complication of heparin therapy induced by antibodies to heparin/platelet factor 4 (PF4) complexes. We investigated the diagnostic performance of four commercial immunoassays that detect the anti-heparin/PF4 antibody. METHODS: Four different anti-heparin/PF4 antibody assays were performed in 39 patients with suspected HIT: HemosIL AcuStar HIT-IgG, HemosIL AcuStar HIT-total antibody (Ab) (Instrumentation Laboratory, USA), STic Expert HIT (Diagnostica Stago, France), and PF4 Enhanced (Immucor GTI Diagnostics, USA). Patients were diagnosed with HIT when the Chong score was > or =5. RESULTS: The estimated sensitivity and specificity for diagnosis of HIT were 33.3% and 80.0% for AcuStar HIT-IgG, 55.6% and 53.3% for AcuStar HIT-total Ab, 100.0% and 37.9% for STic Expert HIT, and 33.3% and 66.7% for PF4 Enhanced. All specificities significantly increased when 4Ts scores were included in the diagnosis. The areas under the curves (AUCs) for predicting thrombosis in the AcuStar HIT-IgG, AcuStar HIT-total Ab, and PF4 Enhanced assays were 0.639, 0.522, and 0.681, respectively. When the results of each assay were analysed along with 4Ts scores, the AUC increased to 0.927 in the AcuStar HIT-IgG assay and 0.944 in the AcuStar HIT-total Ab and PF4 Enhanced assays. CONCLUSIONS: The STic Expert HIT assay had high sensitivity but low specificity for diagnosis of HIT. The performances of the three other immunoassays were comparable to each other. Specificity significantly increased when assay data were combined with 4Ts scores. Differences in the diagnostic performance of the four immunoassays were not evident, and simultaneous consideration of clinical scoring systems improved performance.
Antibodies ; Area Under Curve ; Diagnosis* ; Heparin ; Humans ; Immunoassay* ; Sensitivity and Specificity ; Thrombocytopenia* ; Thrombosis