A Rare Case of Polycythemia Vera Following Acute Undifferentiated Leukemia Remission

육희정,조치현,이종한,최철원,임채승,윤수영 대한진단검사의학회 2014 Annals of Laboratory Medicine Vol.34 No.6

Polycythemia vera (PV) is a myeloproliferative neoplasm (MPN) characterized by the abnormal proliferation of red blood cells, and it is associated with leukocytosis and thrombocytosis [1]. A Janus kinase 2 ( JAK2 ) V617F mutation is found in 95% of PV patients and influences its pathogenesis and diagnosis [1-4]. Generally, AML development is a late event in PV patients [1, 5], and leukemic transformation occurs in 5-15% of patients [4]. We report a case of PV after complete remission (CR) of acute undifferentiated leukemia.

간경화 환자에서 항-M 항체와 동시에 검출된 항-f(ce) 항체 증례보고

육희정,김진석,황상현,고대현,오흥범 대한수혈학회 2022 大韓輸血學會誌 Vol.33 No.1

The Rh blood group system has C, D, E, c, and e as the main antigens, but ce(f) has been reported as a compound antigen. Anti-f(ce) is an unexpected antibody (Ab) against the ce(f) compound antigen. This paper reports a case with anti-f(ce) and anti-M Abs in a patient with liver cirrhosis. A 47-year-old male patient was repeatedly admitted to hospital due to recurrent hepatic encephalopathy. He showed disorientation and was admitted. A packed red blood cells (pRBCs) transfusion was required, and Ab identification test identified anti-f(ce) and anti-M Abs. Anti-f(ce) Ab can cause fetal neonatal hemolytic disease and a clinically serious hemolytic transfusion reaction (HTR), and anti-M Ab can cause a HTR when it reacts at 37℃. RBCs with Rh haplotype of CDe and negative for M antigen were transfused to the patient. There was no HTR. The possibility of an anti-f(ce) Ab was not considered when an unexpected Ab screening/identification test was performed. It was simply reported as an ‘unknown alloantibody’. Therefore, laboratory physicians should consider Abs to the Rh compound antigen when Abs to Rh antigens are identified, and efforts should be made to identify them to gain basic knowledge about Abs against Rh compound antigens. (Korean J Blood Transfus 2022;33:32-38)

Current Status of External Quality Control for the Classification of Complex Antibodies on the Unexpected Antibody Identification Test

육희정,Jin Seok Kim,Yousun Chung,Sang-Hyun Hwang,Heung-Bum Oh,Hyungsuk Kim,Dae-Hyun Ko 대한임상검사정도관리협회 2021 Journal of Laboratory Medicine And Quality Assuran Vol.43 No.4

항-S 항체에 의한 태아신생아용혈성질환 1예: 국내 첫 보고

육희정,김영곤,정유나,곽정숙,김하늬,이은희,김대원 대한수혈학회 2016 大韓輸血學會誌 Vol.27 No.2

A full term male infant was admitted to the neonatal intensive care unit due to jaundice and mild hemolytic anemia within the first 24 hours of his life. The total serum bilirubin level was 11.2 mg/dL at 24 hours of age. The patient was RhD positive and blood group A, and his mother was RhD positive and blood group B. The direct and indirect antiglobulin tests of the infant were all positive. On antibody screening and identification tests, anti-S antibodies were identified from both the infant and mother. The RBC phenotyping for S antigen revealed positive for infant and negative for mother. This report documents the first case of hemolytic disease of the fetus and newborn due to the anti-S antibody in Korea. 만삭 남아가 출생 첫 24시간 이내 보인 황달과 경도의 용혈성빈혈로 신생아집중치료실에 입원하였다. 총빌리루빈 수치는 출생 첫 24시간에 11.2 mg/dL이었다. 환아의 혈액형은 A형 RhD 양성이었고, 산모는 B형 RhD 양성이었다. 환아의 직접및 간접항글로불린 검사는 양성이었고 항체선별검사 및 항체동정검사 결과 환아와 산모 모두 항-S 항체가 동정되었고 산모와 환아에게 시행한 S항원에 대한 적혈구표현형검사 결과 산모는 음성, 환아는 양성을 보였다. 본 증례는 국내에서 항-S 항체에 의한 태아신생아용혈성질환의 첫 보고이다.

혈장 제제에도 백혈구 제거가 필요한가?

육희정,정유선,김형석,고대현 대한수혈학회 2022 大韓輸血學會誌 Vol.33 No.3

Leukoreduction is a process in which the white blood cells (WBCs) in cellular products are intentionally reduced to bring down the risk of adverse transfusion reactions, such as febrile nonhemolytic transfusion reactions or human leukocyte antigen alloimmunization. So far, Korea has not considered leukoreduction of plasma products. However there have been recommendations for leukoreduction to improve patient outcomes. The authors have experience in measuring WBCs and WBC fragment counts in plasma products and have shown that the WBC and their fragments could be efficiently removed using leukoreduction filters. Hence, it may be beneficial to begin discussions on the necessity of using leukoreduction of plasma products. (Korean J Blood Transfus 2022;33:182-184)

수혈된 농축적혈구의 신선도에 영향을 미치는 요인

육희정,조윤정,조치현,최지선,남명현,임채승,이창규 대한수혈학회 2014 大韓輸血學會誌 Vol.25 No.3

Background:The relationship between the storage age of packed red blood cells (pRBCs) and clinical outcomes is controversial. However, no systematic study regarding how fresh pRBCs were transfused to patients have been available so far. Therefore, we newly defined concepts for supply age (period from blood collection to supply to hospital), storage age (period from supply to transfusion to patient), and transfusion age (supply age plus storage age) and investigated them. The factors affecting each age were also analyzed. Methods:A retrospective analysis for three ages of pRBCs was performed for patients who were transfused ≥1 pRBCs unit at three university hospitals between January 2009 and December 2013. Inventory age (period from blood collection to inventory check point at each blood bank) was prospectively checked on a daily basis for 30 days. Four blood centers and blood groups of transfused pRBCs were included. Results:The mean supply, storage, and transfusion ages of pRBCs were 6.2, 6.0, and 12.0 days, respectively. 58%, 61%, and 66% of total transfused pRBCs were in a fresh category of supply, storage, and transfusion ages correspondingly. Storage and transfusion ages were affected by ABO blood group, hospitals, and years in listing orders. Inventory age was mainly affected by ABO blood group and hospitals. Conclusion:The freshness of transfused pRBCs was affected by hospitals and blood centers. Therefore, using the supply, storage, transfusion, and inventory ages as new norms can be useful to establishment of inventory and supply policies of hospitals and blood centers.

국내 10개 의료기관들의 수혈관리실 운영 현황

육희정,정유선,김형석,황상현,오흥범,고대현 대한수혈학회 2021 大韓輸血學會誌 Vol.32 No.3

Background: According to the revision of the Blood Management Act in 2020, medical institutions that meet certain conditions are obliged to install a transfusion management division in Korea. Therefore, this study assessed the management status of the transfusion management division at major medical institutions. Methods: From August 7th to August 18th, 2021, a survey questionnaire was given to laboratory physicians of 10 major medical institutions in Korea, and the installation and operation of the transfusion management division were surveyed. Results: The medical institutions that participated in this survey completed a transfusion management division in the first half of the year. Doctors, nurses, and medical technologists were assigned as medical personnel, and all laboratory physicians were leading the work as the head of the transfusion management division. Regarding the tasks performed at the transfusion management division, all medical institutions conducted a transfusion appropriateness assessment, education related to transfusion, and adverse transfusion reactions. Most medical institutions had difficulties because there was an insufficient basis to calculate the workforce and budget in installing and operating the transfusion management division. Conclusion: There are rarely reference materials for the practice and operation of the transfusion management division, which has no precedent in Korea, so it is often difficult for medical institutions to prepare it. This study will be a reference for medical institutions that need to install a transfusion management division in the future. Efforts should be made to legislate transfusion management fees focused on the academic community. (Korean J Blood Transfus 2021;32:174-180)

팜유와 혼합유의 저장 및 튀김시 이화학적 성질변화

안명수,육희정 성신여자대학교 생활문화연구소 1994 生活文化硏究 Vol.8 No.-

Identification of the ABOcis-AB04 Allele With a Unique Substitution C796A: The First Case in Korea

윤정,육희정,장정희,장미애,최지호,남명현,최지선,임채승 대한진단검사의학회 2016 Annals of Laboratory Medicine Vol.36 No.6

급성골수백혈병 환자에서 발견된 자가 항-M 항체 증례 보고

홍윤지,김진석,육희정,정유선,김형석,황상현,오흥범,고대현 대한진단검사의학회 2023 Laboratory Medicine Online Vol.13 No.1

The anti-M antibody is a naturally occurring antibody and generally active below 37˚C, with optimum activity at 4˚C. Since auto-anti-M antibody was first reported in 1970, twenty cases have been described. The auto-anti-M antibody could be presented with a negative direct antiglobulin test result and not be associated with anemia or adverse symptoms. Therefore, it is likely to be missed during the routine serologic procedure. Here, we report the first case of auto-anti-M antibody in Korea. A 73-year-old male with relapsed acute myeloid leukemia was admitted with general weakness and atypical pneumonia. The underlying disease created a need for frequent transfusions due to anemia and thrombocytopenia. In the pre-transfusion test, unexpected and not previously seen antibodies were identified as anti-M antibodies and confirmed. The auto-control result was positive. Antigen tests were performed for the antibody’s accurate specification. Finally, it was confirmed that the patient’s red blood cell phenotype had an M antigen and was reported as an auto-anti-M antibody. To our knowledge, this is the first auto-anti-M antibody case in Korea and the Asian region. 항-M 항체는 주로 자연발생적인 항체로 37˚C 이하에서 반응하며 최적반응 온도는 4˚C인 것으로 알려져 있다. 자가 항-M 항체는 1970년에 처음 보고된 이래로 지금까지 20명의 사례만 보고되어 있다. 이는 자가 항-M 항체가 직접항글로불린검사에서 대부분 음성이며 심각한 임상증상을 유발하지 않기 때문에 통상적인 검사에서 발견되기 힘들기 때문인 것으로 여겨지고 있다. 저자들은 한국에서 처음으로 발견된 자가 항-M 항체의 증례를 보고하고자 한다. 재발한 급성골수백혈병으로 항암치료를 받고 있는 73세 남성이 지속되는 전신쇠약증과 비정형폐렴 소견으로 내원하였다. 기저질환으로 인한 혈색소 감소와 혈소판 감소로 지속적으로 수혈을 받아왔다. 입원 후 수혈전검사에서 이전에는 나타나지 않았던 비예기항체가 확인되어 동정검사를 진행하였다. 항-M 항체와 한랭항체가 확인되었고 자가 대조검사에서 양성반응을 보였다. 정확한 동정을 위해 항혈청시약을 이용한 검사를 진행하였다. 환자의 적혈구 표현형이 M 항원을 가지는 것을 최종 확인하여 자가 항-M 항체로 보고하였다. 본 증례는 한국뿐 아니라 아시아 권역에서 최초로 확인된 자가 항-M 항체에 대한 보고이다.