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李文鎬 대한내과학회 1976 대한내과학회지 Vol.19 No.11
The purpose of the study is to understand the mechanism of hemorrhagic tendency in Korean hemorrhagic fever, which is an unique clinical finding in these disorders. Laboratory analysis was made in 33 patients with Korean hemorrhagic fever with special references to the number, morphology and function of the platelet, coagulation profile and bone marrow examination. In view of reported proposal of disseminated intravascular coagulation in Korean hemorrhagic fever, particular efforts are given to explore the possibility of D.I.C., as FDP level in plasma and urine. Authors also attempts to make comparison of hematologic abnormalities between oliguric and diuretic phases. The results are as following: 1) The mean hemoglobin level during oliguric and diuretic phase was 15.4gm/㎗ and 12.0 gm/㎗, respectively. 2) There is evidence of fragmentation of erythrocytes, as burr cell. 3) The mean WBC count level during oliguric and diuretic phase is 15,800/㎣ and 8,800/㎣, respectively. Neutrophilia with shift to left is most commonly observed. Other features are the increased number of monocytes and occasional atypical lymphocytes in peripheral blood. 4) The mean value of platelet count during early oliguric and diuretic phase is 49,000±21,000/㎣ and 217,500±85,300/㎣, respectively. The mean percentage of giant platelet during oliguric and diuretic phase is 33.3% and 34.0%, respectively. 5) The mean value of bleeding time in oliguric phase and diuretic phase is 2 min 35 sec and 3 min 54 sec, respectively. 6) The mean value of coagulation time is 13 min. 20 sec. in oliguric phase, and 8 min. 34 sec in diuretic phase. 7) In 78.4% of the cases during oliguric phase, prothrombin time is over 15 sec and they returned to normal in most cases during the diuretic phase. 8) The mean fibrinogen level in plasma during oliguric phase and diuretic phase is 186. 9 ㎎% and 294.5 ㎎%, respectively. 9) In 79.2% of the cases during oliguric phase, partial thromboplastin time is normal, and it return to normal in 87. 5% of the cases during diuretic phase. 10) Euglobulin lysis time is normal in 55.6% of the cases during oliguric phase, and it is normal in 83.3% of the cases during diuretic phase. 11) Thrombin time is normal in 17.6% of the cases during oliguric phase, and during diuretic phase it is normal in 50% of the cases. 12) In 72. 7% of the cases during oliguric phase, FDP level in plasma is over 1 : 8 and FDP level in urine is below 1 : 4 during diuretic phase. however FDP level in plasma, and urine is below 1 : 4 and over 1 : 8, respectively. 13) In oliguric phase and earlier days of diuretic phase(within 5 days after diuresis), the platelet aggregation by ADP or epinephrine is markedly decreased, but in later days of diuretic phase, it becomes normal. 14) The mean number of megakaryocytes per 10,000 nucleated cells of bone marrow during the oliguric phase and diuretic phase is 10.1 and 12.4, respectively. There is no definite evidence of increase in number of megakaryocytes in bone marrow during the period of thrombocytopenia.
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