A Correlation of Prothrombin Time in Citrated Specimens and EDTA Specimens Examined by Owren Method / 대한진단검사의학회지

BACKGROUND: Sodium citrate has been used as a coagulation test because factor V and VIII are more stable in a citrated specimen. Ethylenediaminetetraacetic acid (EDTA) has been used for the hematologic test because blood cells are preserved better in the EDTA specimen. Both sodium cit-rate and EDTA have the same principle of anticoagulation. They bind free plasma calcium to pre-vent clotting. This study was performed to see if we could substitute EDTA for sodium citrate in pro-thrombin time. METHODS: Blood samples from 133 patients who underwent the prothrombin time test in our hos-pital and 36 healthy controls were used. Each sample was anticoagulated with both sodium citrate and EDTA. We examined the prothrombin time with citrated specimen and EDTA specimen using the Owren reagent; Nycotest PT and also the Quick reagent; and the IL Test PT-Fibrinogen HS. RESULTS: The mean prothrombin time with EDTA specimen was longer than that with the citrated specimen by the Quick method but was shorter using the Owren method. In the Owren method, there was a significant correlation between mean prothrombin time with the citrated and EDTA spec-imen but not using the Quick method. CONCLUSIONS: The prothrombin time with the citrated and EDTA specimens correlated with each other by the Owren method. This correlation could make it possible to replace sodium citrate with EDTA.

Plasma Exchange in the Treatment of Cyclosporine Induced Hemolytic Uremic Syndrome Following Kidney Transplantaion / 대한임상병리학회지

Hemolytic uremic syndrome is characterized by a triad of clinical findings including microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The precise etiology and pathogenesis of hemolytic uremic syndrome are not established by now. According to clinical reports, hemolytic uremic syndrome is associated with infection(bacteria, virus), connective tissue disease, malignancy, drug and pregnancy. Recently, many investigators have reported that cyclosporine induces hemolytic uremic syndrome. Cyclosporine is one of the immunosuppressants that are essential for kidney transplantation. We experienced one case of hemolytic uremic syndrome that developed after kidney transplantation receiving cyclosporine. A 43-yr-old woman with end-stage renal failure received kidney transplantation from her daughter. After operation, she received cyclosporine for immunosuppression and thrombocytopenia, microangiopathic hemolytic anemia and acute renal failure were developed. She was diagnosed as cyclosporine induced hemolytic uremic syndrome and plasma exchange was started with fresh frozen plasma. The plasma exchange was done 16 times and the clinical symptoms were improved. We present this case with review of literatures.