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Transient Acquired Hemophilia Associated with Mycoplasma Pneumoniae Pneumonia
김민선,PaulE.Kilgore,김선영,강주성,이대열,김정수,황평한 대한의학회 2008 Journal of Korean medical science Vol.23 No.1
Acquired hemophilia is a rare disorder caused by autoantibodies to factor VIII (FVIII) (also referred to as factor VIII inhibitors or anti-FVIII) and may be associated with pregnancy, underlying malignancy, or autoimmune disorders. A 33-month-old girl who presented with hematochezia and ecchymotic skin lesions was diagnosed with Mycoplasma pneumoniae pneumonia by serology and polymerase chain reaction. Hematologic studies showed a prolonged activated partial thromboplastin time (aPTT), partially corrected mixing test for aPTT, reduced levels of FVIII, and the presence of antibodies against FVIII. She was treated conservatively with prednisone and intravenous immunoglobulin (IVIG) without FVIII transfusion and recovered without sequelae. This report provides the first description of acquired hemophilia due to anti-FVIII in association with M. pneumoniae in Korea. We discuss this case in the context of the current literature on acquired hemophilia in children.
Transient Acquired Hemophilia Associated with Mycoplasma Pneumoniae Pneumonia
Kim, Min Sun,Kilgore, Paul E.,Kang, Ju Sung,Kim, Sun Young,Lee, Dae Yeol,Kim, Jung Soo,Hwang, Pyoung Han Korean Academy of Medical Sciences 2008 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.23 No.1
Acquired hemophilia is a rare disorder caused by autoantibodies to factor VIII (FVIII) (also referred to as factor VIII inhibitors or anti-FVIII) and may be associated with pregnancy, underlying malignancy, or autoimmune disorders. A 33-month-old girl who presented with hematochezia and ecchymotic skin lesions was diagnosed with Mycoplasma pneumoniae pneumonia by serology and polymerase chain reaction. Hematologic studies showed a prolonged activated partial thromboplastin time (aPTT), partially corrected mixing test for aPTT, reduced levels of FVIII, and the presence of antibodies against FVIII. She was treated conservatively with prednisone and intravenous immunoglobulin (IVIG) without FVIII transfusion and recovered without sequelae. This report provides the first description of acquired hemophilia due to anti-FVIII in association with M. pneumoniae in Korea. We discuss this case in the context of the current literature on acquired hemophilia in children.
Jacqueline K. Lim,김태희,Paul E. Kilgore,Allison E. Aiello,최병민,이광철,유기환,송영환,김윤경 대한의학회 2014 Journal of Korean medical science Vol.29 No.4
There are limited data evaluating the relationship between influenza treatment andhospitalization duration. Our purpose assessed the association between differenttreatments and hospital stay among Korean pediatric influenza patients. Total 770 children≤ 15 yr-of-age hospitalized with community-acquired laboratory-confirmed influenza atthree large urban tertiary care hospitals were identified through a retrospective medicalchart review. Demographic, clinical, and cost data were extracted and a multivariablelinear regression model was used to assess the associations between influenza treatmenttypes and hospital stay. Overall, there were 81% of the patients hospitalized withlaboratory-confirmed influenza who received antibiotic monotherapy whereas only 4% ofthe patients received oseltamivir monotherapy. The mean treatment-related charges forhospitalizations treated with antibiotics, alone or with oseltamivir, were significantlyhigher than those treated with oseltamivir-only (P < 0.001). Influenza patients treatedwith antibiotics-only and antibiotics/oseltamivir combination therapy showed 44.9% and28.2%, respectively, longer duration of hospitalization compared to those treated withoseltamivir-only. Patients treated with antibiotics, alone or combined with oseltamivir,were associated with longer hospitalization and significantly higher medical charges,compared to patients treated with oseltamivir alone. In Korea, there is a need for morejudicious use of antibiotics, appropriate use of influenza rapid testing.
Lim, Jacqueline K.,Kim, Tae Hee,Kilgore, Paul E.,Aiello, Allison E.,Choi, Byung Min,Lee, Kwang Chul,Yoo, Kee Hwan,Song, Young-Hwan,Kim, Yun-Kyung The Korean Academy of Medical Sciences 2014 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.29 No.4
<P>There are limited data evaluating the relationship between influenza treatment and hospitalization duration. Our purpose assessed the association between different treatments and hospital stay among Korean pediatric influenza patients. Total 770 children 15 yr-of-age hospitalized with community-acquired laboratory-confirmed influenza at three large urban tertiary care hospitals were identified through a retrospective medical chart review. Demographic, clinical, and cost data were extracted and a multivariable linear regression model was used to assess the associations between influenza treatment types and hospital stay. Overall, there were 81% of the patients hospitalized with laboratory-confirmed influenza who received antibiotic monotherapy whereas only 4% of the patients received oseltamivir monotherapy. The mean treatment-related charges for hospitalizations treated with antibiotics, alone or with oseltamivir, were significantly higher than those treated with oseltamivir-only (P < 0.001). Influenza patients treated with antibiotics-only and antibiotics/oseltamivir combination therapy showed 44.9% and 28.2%, respectively, longer duration of hospitalization compared to those treated with oseltamivir-only. Patients treated with antibiotics, alone or combined with oseltamivir, were associated with longer hospitalization and significantly higher medical charges, compared to patients treated with oseltamivir alone. In Korea, there is a need for more judicious use of antibiotics, appropriate use of influenza rapid testing.</P>
Prevalence of rotavirus diarrhea among hospitalized under-five children
Mathew, M. A.,Paulose, A.,Chitralekha, S.,Nair, M. K.,Kang, G.,Kilgore, P. INDIAN PEDIATRIC 2014 Indian pediatrics Vol.51 No.1
Objectives: To estimate the prevalence of rotavirus diarrhea among hospitalized children less than 5 years of age in Kerala State and to determine the circulating strains of rotavirus in Kerala.Design: Multicenter, cross-sectional study.Setting: Eight representative hospitals in Kunnathunadu Thaluk, Ernakulam district, Kerala.Participants: Children in the age group under 5 yearsMethods: Hospitalized children admitted with acute diarrhea were examined and standardized case report form was used to collect demographic, clinical and health outcome. Stool specimens were collected and ELISA testing was done. ELISA rotavirus positive samples were tested by reverse transcription PCR for G and P typing (CMC Vellore).Results: Among the 1827 children, 648 (35.9%) were positive for rotavirus by the Rotaclone ELISA test. The prevalence of rotavirus diarrhea in infants less than 6 months of age was 24.7%; 6-11 months 31.9%; 12-23 months 41.9%; 24-35 months 46.9%; and 33.3% in 36- 59 months. Rotavirus infections were most common during the dry months from January through May. GIP[8] (49.7%) was the most common strain identified followed by G9P[8] (26.4%), G2P[4] (5.5%), G9P[4] (2.6%) and G12P[6] (1.3%).Conclusions: The prevalence of rotavirus diarrhea among hospitalized children less than 5 years is high in Ernakulam district, Kerala State.