Plasma Exchange in a Patient with Antineutrophil Cytoplasmic Antibody-associated Vasculitis / 대한수혈학회지

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a systemic autoimmune disease with a poor prognosis in untreated patients, and combination therapy with steroidsand cyclophosphamide is the current standard treatment. Treatment with immunosuppressive agents results in high remission rates; however, there is a considerable morbidity related to the immunosuppressive state, such as life-threatening infections. To reduce serious immunosuppressant-related adverse effects, potentially promising treatment options, including plasma exchange, cytapheresis, administration of intravenous immunoglobulin and TNF-alpha blocking agents have been developed. We performed plasma exchange with steroid pulse therapy for a 52 year-old female patient with pulmonary hemorrhagewith ANCA-associated crescentic glomerulonephritis. After combination therapy, the pulmonary hemorrhage and renal function recovered and myeloperoxidase (MPO)-ANCA decreased.

Comparative Analysis of Bronchoalveolar Lavages in Interstitial Lung Diseases / 대한진단검사의학회지

BACKGROUND: This study was purposed to find out the differences in the lymphocyte subsets and differential cell counts of the bronchoalveolar lavage (BAL) fluid in patients with interstitial lung disease (ILD) and to analyze the differences according to their ages, gender and smoking habits. METHODS: BAL fluid samples of 141 ILD patients were examined for lymphocyte subsets and differential cell counts, and the differences among the patients were analyzed according to their diseases. Then, within the three most common disease groups, the differences were further analyzed by the age, gender and smoking habit of the patients. RESULTS: There were no statistically significant differences in total cell counts (per millimeters of BAL fluid) among the patient groups with each ILD. However, significant differences were observed in the percentages of neutrophils, lymphocytes, eosinophils, and macrophages of BAL fluid. Also, in lymphocyte subset analyses, the percentages of total T cells, B cells, CD4+ T cells, CD8+ T cells, CD4/CD8 T cell ratios, and NK cells were significantly different among the patients with each ILD. However, within the same disease group, there were no differences in differential cell counts and lymphocyte subset analyses according to the age, smoking habit, and gender of the patients. CONCLUSIONS: Although the age, smoking habit and gender did not have an effect on the BAL fluid analyses among the patients with the same ILD, there were significant differences among the patients with each ILD; therefore, the differential cell counts and lymphocyte subset analyses of BAL fluid can be useful in differential diagnosis for determining the types of ILD.

Two Cases of Heparin-Induced Thrombocytopenia Diagnosed by Particle Gel Immunoassay / 대한진단검사의학회지

Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy. It represents initially as thrombocytopenia and is associated with venous or arterial thrombosis. It has been reported that platelet factor 4/heparin complex antibody plays an important role in the pathogenesis of HIT. Patients on hemodialysis have a high risk of developing HIT because heparin is administrated in hemodialysis as anticoagulant. Thrombocytopenia usually occurs 5 to 10 days after the onset of administration, but occasionally, it may occur rapidly in patients who have preformed antibodies from recent heparin use. We report here 2 cases of HIT with platelet factor 4-heparin reactive antibody in hemodialysis patients.