Journal of the Korean Pediatric Society 1991;34(6):826-831.
Published online June 30, 1991.
A case of pancytopenia associated with mycoplasmal pneumonia.
Young Mee Yoo1, Beom Soo Park1, In Sang Jeon1, Hee Young Shin1, Hyo Seop Ahn1, Se Jung Sohn2
1Department of Pediatrics, Seoul Nationl University College of Medicine, Seoul, Korea
2Department of Pediatrics, Choong Ang Kil Hospital, Incheon, Korea
Mycoplasma 폐렴에 동반된 범혈구 감소증 1례
유영미1, 박범수1, 전인상1, 신희영1, 안효섭1, 손세정2
1서울대학교 의과대학 소아과학교실
2인천 중앙 길병원 소아과
Received: 17 October 1990   • Accepted: 15 December 1990
Abstract
Mycoplasma pneumoniae infection is manifestated as pneumonia and extra-pulmonary symptoms such as hematologic, neurologic, gastrointestinal, musculoskeletal, dermatologic and cardiac manifes- tations. Among the hematologic changes, hemolytic anemia is most frequently seen. Throm- bocytopenic purpura, lymphocytosis or rarely lymphopenia, elevated erythrocyte sedimentation rate, positive direct Coombs test, reticulocytosis and DIC are known hematologic features. This 12 years old female patient was presented with pneumonia and pancytopenia. Bone marrow biopsy showed less than 10% cellularity which was compatible with aplastic anemia. Chest X-ray finding revealed patchy hazy density in superior and lateral segments of the left lower lobe with collapse. On the fourth hospital day, cold agglutinin titer was 1:1,024 and anti-mycoplasma antibody titer was 1:5,120. On the thirteenth hospital day, with improvement of pneumonia, those titers became 1: 512 and 1:5,120 respectively. Gradually reticulocyte count increased and the features of hemolytic anemia became more prominent with improvement of chest X-ray and symtoms after treatment with antibiotics. We concluded that she sufferred with mycoplasmal pneumonia and the initial pancytopenia was the ‘aplastic crisis’ of hemolytic anemia which was caused by Mycoplasma pneumoniae infection (pneumonia).
Key Words: Mycoplasmal infection, Pancytopenia, Coombs positive hemolytic anemia




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