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22대 대한민국 국회 국회정보길라잡이 국회의원검색
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소장정보 검색

국회도서관 홈으로 정보검색 소장정보 검색
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Contents

Abstract 5

Introduction 6

Materials and Methods 8

Results 9

Discussion 10

References 14

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The diagnostic algorithm for primary immune thrombocytopenia purpura is mainly based on eliminations of other possible causes. Besides other evaluations, the need for a bone marrow examination for ITP patients is till contentious. This study was designed to investigate the clinical characteristics of patients with isolated thrombocytopenia who have gone through a bone marrow examination.

The records of thirty five patients with thrombocytopenia that had taken bone marrow aspiration between December 2008 and January 2011 were retrospectively reviewed for their clinical characteristics. The purpose of this study is to evaluate bone marrow aspiration procedure as a diagnostic tool of immune thrombocytopenia purpura by analyzing post-aspiration clinical courses. Furthermore, fluorescent antinuclear antibody test (FANA) was evaluated as a diagnostic tool to rule out other autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, Hashimoto's thyroiditis and pernicious anemia.

Out of 35 patients with thrombocytopenia, two cases (6%) that were not qualified for the bone marrow aspiration indication from the guideline of the American Society of Hematology showed decreased megakaryocyte counts from bone marrow aspiration study. Thus, they could be eliminated from ITP. One of them developed pancytopenia after 6 months during thrombocytopenia work-ups. This patient is finally diagnosed with aplastic anemia and is now under the appropriate treatments. The other patient has been in the clinic for less than a year and still on the process of differential diagnosis. In addition, the FANA test to rule out auto-immune diseases which can cause the secondary thrombocytopenia definitely has proven its use; 8 patients (24%) were positive for the FANA among 33 patients with non-decreasing megakaryocyte counts.

In summary, judging from the initial feature of thrombocytopenia could be insufficient for differential diagnosis of ITP because other underlying diseases could mimic isolated thrombocytopenia; the bone marrow aspiration could provide a clear guidance.

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