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Korean J Med > Volume 86(3); 2014 > Article
The Korean Journal of Medicine 2014;86(3): 362-366.
쯔쯔가무시병에 동반된 면역성 혈소판 감소증 1예
김현아, 이지연, 현미리, 류성열
계명대학교 의과대학 감염내과학교실
A Case of Immune Thrombocytopenic Purpura Associated with Scrub Typhus
Hyun Ah Kim, Ji Yeon Lee, Miri Hyun, Seong-Yeol Ryu
Department of Infectious Disease, Keimyung University School of Medicine, Daegu, Korea
Corresponding Author: Seong-Yeol Ryu ,Tel: +82-53-250-7915, Fax: +82-53-250-7994, Email: 121rsy@dsmc.or.kr
Received: 2013. 2. 18;  Accepted: 2013. 8. 8.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Thrombocytopenia is a common manifestation of rickettsial disease. However, the pathogenesis of thrombocytopenia in many rickettsial diseases is poorly understood. Thrombocytopenia may be associated with consumption due to widespread endothelial damage or disseminated intravascular coagulation, hypersplenism, decreased marrow production, and immune-mediated platelet destruction. Some reports have found anti-platelet antibodies detected in thrombocytopenic patients with rickettsial disease. In addition to thrombocytopenia, facial palsy and Guillain-Barré syndrome were also reported as immune-mediated phenomena in scrub typhus. Here we report a case diagnosed as immune-mediated thrombocytopenia associated with scrub typhus. This is the first report of immune thrombocytopenic purpura (ITP) associated with scrub typhus in Korea. The patient exhibited eschar with a high titer of anti-tsutsugamushi antibody, thrombocytopenia, severe gastrointestinal hemorrhage, and purpura on the lower region of both legs. After steroid treatment, the sustained thrombocytopenia recovered. (Korean J Med 2014;86:362-366)
Keywords: Scrub typhus; Autoimmune thrombocytopenia; Gastrointestinal hemorrhage
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