Browsing by Author "Pravinwan Thungthong"

Filter results by typing the first few letters
Now showing 1 - 8 of 8
  • No Thumbnail Available
    PublicationMetadata only
    Atypical complication in an adult patient with dengue and autoimmune hemolytic anemia: A case report
    (2021-02-01) Supat Chamnanchanunt; Pravinwan Thungthong; Chajchawan Nakhakes; Putza Chonsawat; Tawatchai Suwanban; Faculty of Tropical Medicine, Mahidol University; Hospital for Tropical Diseases, Bangkok; Rajavithi Hospital
    Severe dengue infection is associated with life-threatening complications, including severe bleeding. The bleeding tendency is typically associated with the shock phase of infection, for which blood replacement may be needed. However, repetitive blood transfusion can lead to volume overload. Administration of recombinant activated factor VII (rFVIIa) might be used to counteract bleeding without inducing volume overload. We describe the case of a patient with severe dengue infection who presented with intractable bleeding; he was initially treated with massive blood transfusions, which resulted in volume overload. He was then treated with rFVIIa to reverse the bleeding. During the second week of his hospitalization, his hematocrit dropped precipitously, and autoimmune hemolytic anemia was diagnosed. Supportive treatment was provided until recovery. Autoimmune hemolytic anemia is a rare complication in adult patients with dengue. Supportive care was effective for this atypical complication.
  • No Thumbnail Available
    PublicationMetadata only
    Autoimmune hemolytic anemia and autoantibodies in a patient with Plasmodium falciparum infection: Report of a rare case and review of the literature
    (2017-10-01) Supat Chamnanchanunt; Pravinwan Thungthong; Sirvicha Kudsood; Waraporn Somwong; Manassamon Hirunmassuwan; Mahidol University; Rajavithi Hospital; Chulabhorn Hospital
    © 2017 Supat Chamnanchanunt et al. Background: Anemia is a common problem among patients with malaria infection, which induces hemolysis during treatment. A few patients present with autoimmune hemolytic anemia (AIHA) and autoantibodies, such as autoanti-E and autoanti-I, during malaria infection. Objective: To report the clinical response of a patient with Plasmodium falciparum malaria infection with a hemolytic condition. Methods: We reviewed medical records of a patient with P. falciparum malaria and related literature. Results: Our patient presented with P. falciparum malaria infection and received artesunate and ceftriaxone to cover potential tropical infectious diseases. After malaria parasite was eradicated, her hemoglobin declined, and AIHA and autoantibodies were found, explaining the cause of anemia. Corticosteroid was given at a standard dosage, and her hemoglobin became normal within 1 week. Conclusion: Patients with falciparum malaria and both AIHA and autoantibody complications are rare. Our patient responded to malaria eradication and corticosteroid treatment. Most cases reported seem to respond to corticosteroid with a variety of recovery times. However, corticosteroids might increase the severity of infection; more clinical data to support a standard regimen to treat properly rare hematologic complications (AIHA and autoantibodies) in malaria patients are warranted.
  • No Thumbnail Available
    PublicationMetadata only
    Dengue virus infection in a patient with chronic myeloid Leukemia
    (2012-11-19) Supat Chamnanchanunt; Pravinwan Thungthong; Chajchawan Nakhakes; Tawatchai Suwanban; Kunapa Iam-Arunthai; Mahidol University; Rajavithi Hospital
    This is a case report of a patient with chronic myeloid leukemia (CML) undergoing imatinib treatment who became infected with dengue virus. The patient presented with classic dengue symptoms, along with early minor bleeding (blood-stained sputum) during the first 5 days of illness. Continuous inpatient imatinib treatment for CML was given without blood transfusion. The hemoglobin and white blood-cell count slowly improved over 30 days while recovering from the dengue viral infection. The patient recovered from the dengue virus infection without complication. Clinical monitoring of hematologic changes is needed in dengue patients undergoing anticancer treatment.
  • No Thumbnail Available
    PublicationMetadata only
    False-positive dengue IgM test result in a patient with systemic lupus erythematosus: A case report
    (2020-10-01) Supitcha Kamolratanakul; Pravinwan Thungthong; Chajchawan Nakhakes; Chokchai Kittiyanpanya; Putza Chonsawat; Supat Chamnanchanunt; Lerdsin Hospital; The Hospital for Tropical Diseases, Bangkok; Mahidol University; Rajavithi Hospital
    © 2020 Supitcha Kamolratanakul et al., published by Sciendo 2020. Dengue virus infection most commonly has mild-to-moderate nonspecific clinical presentations that overlap with other diseases. Dengue-specific tests are commonly used for those patients with acute febrile illness in dengue-endemic areas. There is one study in vitro that showed a false-positive dengue-immunoglobulin M (dengue IgM) test for blood from a patient with systemic lupus erythematosus (SLE). Here, we demonstrated a false-positive dengue IgM test in a patient with SLE. The patient had fever, cytopenia, and a skin rash, but her clinical variables more closely matched with the criteria for SLE than the dengue infection. Vasculitis-like-lesions supported prednisolone administration and her clinical symptoms improved. This case highlights that some patients with SLE can be misdiagnosed as having a viral infection. These two diseases have similar clinical findings, such as acute febrile illness, but they are different in terms of their treatments and disease prognosis.
  • No Thumbnail Available
    PublicationMetadata only
    False-positive nonstructural protein 1 antigen in a patient with philadelphia chromosome-positive acute lymphoblastic leukemia: A case report with literature review
    (2021-01-01) Supat Chamnanchanunt; Pravinwan Thungthong; Asrinda Abdulkanan; Chajchawan Nakhakes; Hospital for Tropical Diseases, Bangkok; Mahidol University; Rajavithi Hospital
    Objective: Mistake in diagnosis Background: A rapid investigation of dengue viral infection is needed for physicians who manage patients with suspected dengue infection. The nonstructural protein 1 (NS1) test kit is commonly used to diagnose patients with acute febrile illness in dengue-endemic countries, although this test kit can yield false-positive results. The Dengue NS1 test kit mostly relies on cross-reaction among febrile illness patients with other viral infections rather than malignancies. Case Report: A 52-year-old male patient presented with 3 days of fever, intermittent gum bleeding, weight loss, and mucocutaneous bleeding. He was transferred to a second hospital with acute febrile illness. Both dengue NS1 antigen test kits were positive from the 2 hospitals where he was previously treated. Fever and cytopenia persisted, and then the dengue RT-PCR test was performed to establish the cause of illness. A peripheral blood smear was reviewed and showed blast cells. A bone marrow examination was done to test for the compatibility of lymphoblastic leukemia. The flow cytometry test showed B cells ALL with Philadelphia-positive chromosome. Finally, the result of the dengue RT-PCR test was negative. Conclusions: Our patient presented with fever and viral-like illness, but he was finally diagnosed with Ph+ ALL. We demonstrated the first case of false-positive dengue NS1 antigen in a Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) patient. Moreover, we reviewed the literature to gather information on false-positive results using the dengue NS1 test kit. The dengue NS1 test kit is useful and produces reliable clinical findings, especially in patients with hematological malignancies.
  • No Thumbnail Available
    PublicationMetadata only
    Janus kinase 2 negative polycythemia vera
    (2015-10-01) Pravinwan Thungthong; Supat Chamnanchanunt; Tawatchai Suwanban; Chajchawan Nakhakes; Kunapa Iam-Arunthai; Rajavithi Hospital; Mahidol University
    Background: A Janus kinase 2 (JAK2) mutation polycythemia vera (PV) is a common manifestation of stem cell disorder. However, available data on the clinical and treatment response of JAK2-negative PV patients are limited. Objectives: We report the case and clinical course of a patient with PV and left hemiparesis who was JAK2V617- negative. Methods: We conducted a literature review and compared our patient with previously published reports of JAK2-negative patients with PV. Results: Our patient presented with hemiparesis without a previous history of hematological disease. He was diagnosed with PV based on the British Committee for Standards in Haematology guidelines 2007. He underwent only phlebotomy with subsequent improvement of his neurological condition. He was discharged with therapeutic phlebotomy for one and a half months. Conclusions: Although this rare condition required complex diagnostic criteria, the patient achieved good clinical outcome with therapeutic phlebotomy alone.
  • No Thumbnail Available
    PublicationMetadata only
    Polycythemia vera concomitant with renal angiomyolipoma: Case report and clinical outcome
    (2017-02-01) Supat Chamnanchanunt; Pravinwan Thungthong; Niphon Praditphol; Kunapa Iam-Arunthai; Jirapong Dowreang; Chajchawan Nakhakes; Tawatchai Suwanban; Mahidol University; Rajavithi Hospital
    Background: Polycythemia vera has been found in a wide range of hematopoietic tissue disorders, but rarely concomitant with renal abnormality. To our knowledge there is only one available report of a patient with polycythemia vera concomitant with renal angiomyolipoma, and the report does not cover the clinical course of this rare finding. Objectives: To report the presentation and clinical course of a patient with polycythemia vera concomitant with right renal angiomyolipoma. Methods: We retrospectively reviewed the medical records of a patient with polycythemia vera who presented with renal angiomyolipoma. Results: Our patient presented with a right renal mass and polycythemia vera diagnosed by a point mutation in the gene for Janus kinase 2. The mass was diagnosed as renal angiomyolipoma on histopathology. After partial nephrectomy, she was prescribed a low dosage of hydroxyurea without the return of erythrocytosis for a year. Conclusions: Polycythemia vera responded well to low dosage hydroxyurea, which controlled erythrocytosis after removing the renal mass.
  • No Thumbnail Available
    PublicationMetadata only
    Primary granulocytic sarcoma: A rare presentation of an ovarian mass
    (2014-01-01) Supat Chamnanchanunt; Chajchawan Nakhakes; Pravinwan Thungthong; Tawatchai Suwanban; Kunapa Iam-arunthai; Napat Sukgasi; Maleerat Sutherat; Mahidol University; Rajavithi Hospital; Thailand Ministry of Public Health
    Background: Primary granulocytic sarcoma (GS) only rarely presents with an ovarian mass classified as extramedullary myeloid progenitor tumor cells. Few patients with cases of primary GS survive after systemic chemotherapy.Objective: To present a case of primary GS treated with complete course of chemotherapy. The patient is currently in complete remission.Methods: Retrospective review of medical records and comparison with previous case reports.Results: A 41-year-old woman presented with an ovarian mass of 6 months duration. There was no previous history of hematologic disease or presence of leukemic cells in other organs at the time of diagnosis. Immunohistochemistry confirmed the diagnosis. She received complete course of chemotherapy, after which complete remission was achieved.Conclusion: A case of primary granulocytic sarcoma of the ovary was successfully treated with chemotherapy. This disease needs careful diagnosis and appropriate treatment for a good outcome.