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The Korean Journal of Medicine 2007;73(2): 183-191.
원저 : 말라리아 환자의 간스캔에서 폐섭취군과 비섭취군의 혈액생화학적 지표 및 임상양상의 비교
양병윤, 김종수, 정재혁, 김지훈, 이윤영, 최원제, 서승오, 정준오, 김은실, 안석진, 박상준, 김윤권, 김영중, 김소연, 조민구
A comparative study of the clinical features and hematobiochemical indices between the lung-uptake group and the non-lung-uptake group of malarial patients undergoing liver scanning
Byeong Yun Yang, Jong Soo Kim, Jae Hyuk Jung, Ji Hoon Kim, Yun Young Lee, Won Je Choi, Seungoh Seo, Junoh Chung, Eun Sil Kim, Seok Jin Ahn, Sang Jun Park, Yun Kwon Kim, Young Jung Kim, ,
Department of Pulmonology and Critical Care Medicine, Chonnam National University Medical School, Gwangju, Korea
Background : Lung uptake during liver scanning has been considered as a passing phenomenon related to several diseases, and especially infectious diseases and malignancy. Some reports have shown diffuse lung uptake during liver scanning of malarial patients. Therefore, we tried to determine the relationship between the abnormalities of the clinical features, including the hematobiochemical indices and the lung uptake during liver scanning, by analyzing the information of the malarial patients. Methods : We performed 99mTechnethium(Tc)-sulfur colloid liver scanning on 20 of the 45 malarial patients who were admitted from 1999 to 2004. We divided them into two groups, the Lung-Uptake (LU) group and the Non-Lung-Uptake (NLU) group. We analyzed the hematobiochemical indices and clinical features, including the respiratory symptoms, between the two groups. Results : 10 of the 20 malarial patients showed lung uptake on the liver scan. The mean platelet counts were 74,000/L and 165,000/L, respectively, in the LU group and the NLU group (p=0.012). Also, the mean total cholesterol levels were 80.3mg/dL and 105.7 mg/dL, respectively, in the LU group and the NLU group (p=0.033). The scores ofthe bone marrow (BM) uptake in the LU group were higher than those in the NLU group (p=0.008). Yet the other values such as Hb, ALT, albumin and total bilirubin were not statistically significant, nor were the peak body temperatureand other features. Conclusions : Half of the patients had lung uptake on the liver scanning, and this may be considered as a characteristic of vivax malaria. The BM uptake during liver scanning in the LU group was more increased, and this is supposed to be a consequence of hyperstimulated reticuloendothelial system, which was accompanied by thrombocytopenia and a lower level of total cholesterol in malarial patients.(Korean J Med 73:183-191, 2007)
Keywords: Malaria, 99mTc-sulfur colloid scan, Lung uptake, Reticuloendothelial system
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