Magnetic resonance imaging of extraocular rectus muscles abnormalities in acute acquired concomitant esotropia

AIM:To investigate the difference of medial rectus(MR)and lateral rectus(LR)between acute acquired concomitant esotropia(AACE)and the healthy controls(HCs)detected by magnetic resonance imaging(MRI).METHODS:A case-control study.Eighteen subjects with AACE and eighteen HCs were enrolled.MRI scanning data were conducted in target-controlled central gaze with a 3-Tesla magnetic resonance scanner.Extraocular muscles(EOMs)were scanned in contiguous image planes 2-mm thick spanning the EOM origins to the globe equator.To form posterior partial volumes(PPVs),the LR and MR cross-sections in the image planes 8,10,12,and 14 mm posterior to the globe were summed and multiplied by the 2-mm slice thickness.The data were classified according to the right eye,left eye,dominant eye,and non-dominant eye,and the differences in mean cross-sectional area,maximum cross-sectional area,and PPVs of the MR and LR muscle in the AACE group and HCs group were compared under the above classifications respectively.RESULTS:There were no significant differences between the two groups of demographic characteristics.The mean cross-sectional area of the LR muscle was significantly greater in the AACE group than that in the HCs group in the non-dominant eyes(P=0.028).The maximum cross-sectional area of the LR muscle both in the dominant and non-dominant eye of the AACE group was significantly greater than the HCs group(P=0.009,P=0.016).For the dominant eye,the PPVs of the LR muscle were significantly greater in the AACE than that in the HCs group(P=0.013),but not in the MR muscle(P=0.698).CONCLUSION:The size and volume of muscles dominant eyes of AACE subjects change significantly to overcome binocular diplopia.The LR muscle become larger to compensate for the enhanced convergence in the AACE.

Botulinum toxin type A in treating early-stage patients with small-angle acute acquired comitant esotropia

AIM:To investigate botulinum toxin A(BTXA)efficacy on small-angle(≤25Δ)acute acquired concomitant esotropia(AACE)in early-stage patients.METHODS:The electronic medical record data of AACE patients during March 2019 and June 2023 were collected in this retrospective and hospital-based cohort study.A total of 72 small-angle AACE patients received BTXA extraocular muscle injection.Patients were grouped by onset-to-treatment time(Group A:≤6mo,Group B:>6mo).Deviation of esotropia,eye alignment and stereopsis were analyzed at the period of pre/post-injection(1wk,1,3,and 6mo).Orthophoria rate at 6mo(horizontal deviation<10Δand binocular single vision)were considered as outcome index.RESULTS:There were no significant baseline differences(P>0.05)between two groups except onset-to-treatment time(2mo vs 11mo,P<0.001).Higher orthophoria rates were in Group A at last follow-up(94.74%vs 73.53%,P=0.013).Post-BTXA deviations of two groups at 1mo showed no difference(P>0.05);while in 3 and 6mo Group A was significantly smaller than group B(all P<0.001).No statistically significant differences were observed among all post-BTXA deviations of near and distance in Group A.In Group B,deviation at 3mo(near:2Δvs 0,P<0.001;distance:4Δvs 0,P<0.001)and 6mo(near:6Δvs 0,P<0.001;distance:6Δvs 0,P<0.001)was significant increased compared to deviation at 1wk after treatment.Group A showed better stereopsis recovery in last follow-up compared to Group B(80″vs 200″,P=0.002).Both groups obtained improved stereopsis after treatment(Group A:80″vs 300″,P<0.001;Group B:200″vs 300″,P=0.037).CONCLUSION:BTXA is effective for AACE with small deviation(≤25Δ)in early stage.Delayed treatment(>6mo)may reduce BTXA efficacy.Early BTXA intervention benefits long-term eye alignment and stereopsis recovery.

Risk factors for intensive-care-unit-acquired weakness

Wang et al reported 1063 cases from the initial 14 d of intensive care unit(ICU)stay,and analyzed relevant data such as age,comorbidities,recent dosages,vapor pressure dosages,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,which are closely related to ICU-acquired weakness(ICUAW).It is suggested that the length of ICU stay and the duration of mechanical ventilation are the main factors.ICU-AW is the most common neuromuscular injury in the ICU,which affects clinical progression and outcomes of patients.This manuscript helps to improve the early recognition of ICU-AW,thereby reducing mortality and improving prognosis.

Bullous pemphigoid associated with acquired hemophilia A: A case report

BACKGROUND Acquired hemophilia A (AHA) is a rare and potentially severe bleeding disordercaused by circulating autoantibodies against factor Ⅷ (FⅧ). In approximately50% of the patients, the condition is associated with autoimmune diseases,cancers, medication use, pregnancy, and the post-partum period. Bullous pemphigoid(BP) is a chronic autoimmune subepidermal blistering disease associatedwith tissue-bound and circulating autoantibodies against BP antigens 180 (BP180)and 230 (BP230). AHA-associated BP has a high mortality rate;hence, the understandingof this disease must improve.CASE SUMMARY A 69-year-old man presented with erythema, blisters, blood blisters, and crustsaccompanied by severe pruritus for more than 20 days, and ecchymosis andswelling on his left upper arm for 3 days. Pathological examination revealed asubepidermal blister that contained eosinophils. Laboratory tests showed that theBP180 autoantibody levels had increased, isolated activated partial thromboplastintime was notably prolonged (115.6 s), and coagulation FⅧ activity wasextremely low (< 1.0%). Furthermore, the FⅧ inhibitor titer had greatlyincreased (59.2 Bethesda units). Therefore, the patient was diagnosed as having BP associated with AHA, prescribed 0.05% topical halometasone cream, and transferred to a higher-level hospitalfor effective treatment;however, he died after 2 days.CONCLUSION AHA associated BP is rare, dangerous, and has a high mortality rate. Therefore, its timely diagnosis and effectivetreatment are necessary.

Knowledge of Hospital Acquired Infections (HAIs) among Medical Students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria

Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.

Study of the Effectiveness of Papaver Sp. Alkaloids as Future Therapeutic Alternatives against Enterococcus Sp. Causing Hospital-Acquired Septicemic Infections

Background and Objective: In recent years, control of Enterococcus sp. It has been proven in the local medical environment to be a cause of acquired septicemia in various age groups, and medical instruments are considered an effective means of transmitting enterococcal septicemia, and catheters are at the forefront in terms of danger. Based on this risk, this study aimed to monitor the spread of Enterococcus sp., which causes blood poisoning acquired from catheters, and to compare its response to antibiotics with that of those isolated from clinical samples in children, as a first study locally. The effectiveness of alkaloids of different types of Papaver sp. In Syrian plants, they were tested against infection with this bacteria. Materials and Methods: The study dealt with two parts: The first part included collecting clinical samples from the University Children’s Hospital in Damascus/bacterial diagnostic laboratories/then isolating and diagnosing the bacteria by following a set of tests to identify the most prevalent genera and species and comparing their prevalence rate with Enterococcus. The second part;It included collecting plant samples, confirming the species taxonomically, then extracting alkaloids from plant parts (fruit, stem, Flowers), then comparing the extent of resistance of bacterial strains to antibiotics compared to the Enterococcus sp., and then confirming the antibacterial activity of the Papaver sp. alkaloids against Enterococcus sp. Result:In its first part, the study confirmed the significant contribution of the Enterococcus sp. to infections acquired from various sources, largely in catheter tip infections (9.09%) and to a lesser extent in other sources (3.7%), The second part was to confirm the effective-ness of the alkaloid extract of the Papaver sp., especially the two species Papaver syriacum, and Papaver dubium, against Enterococcus sp. with areole diameters that ranged between (15 - 26 mm) for the fruit extract and at a minimum inhibitory concentration (3.12 - 6.25 mml) and then the stem (5 - 20 mm). And the effectiveness of the Flowers extract is very weak to almost non-existent. Conclusions: The catheter and medical sources surrounding the patient constitute a dangerous source of multi-resistant Enterococcus sp., which poses a real threat to the lives of children, with new mechanisms represented by colonization of the skin and the ability to form biofilms Surfaces of medical instruments, with are resistant to a wide range of antibiotics. As an alternative and effective modern source to limit its spread in the future, the alkaloid extract of the fruits and stems of the wild Papaver sp. has proven a strong antibiotic effect, especially the two types: Papaver syriacum and Papaver dubium.

Neuropsychological Profile of a Patient with Acquired Brain Damage Following Vascular Lesion of the Left Anterior Cingulate Cortex

Stroke is a physiological alteration associated with changes in blood flow that can result in sudden-onset cognitive impairment. It has a heterogenous clinical presentation with varying degrees of severity correlated with specific central nervous system zones or areas, and its prognosis is uncertain. This case study describes a 62-year-old male patient with acquired brain damage of the anterior cingulate cortex as a result of an ischemic event in the territory of the left anterior cerebral artery. Cognitive function was assessed using the neuropsychological executive function and frontal lobe test battery (BANFE-2) as well as other neuropsychological tests. The results show a profile of higher mental functions characterized by the presence of dysexecutive syndrome with marked behavioral alteration and diencephalic amnesia. .

Analysis of independent risk factors for acute acquired comitant esotropia

comitant esotropia(AACE).METHODS:A retrospective cohort study was conducted by analyzing 83 patients(case group)with AACE who underwent strabismus correction surgery from January 1,2021 to June 30,2022.Totally 73 outpatient volunteers were recruited during the same period as the normal control group.The case group’s binocular vision time,near and distance esotropia angle,and near stereo vision function were recorded,and the age,gender,refractive status,and best-corrected visual acuity(BCVA)of both groups were analyzed.Additionally,multiple logistic regression analysis was conducted using an eye usage condition questionnaire to determine the independent risk factors for AACE.RESULTS:In the case group,61 patients(73.49%)had myopia,with a mean equivalent spherical power(SE)of-3.35±3.31 D(range:+2.75 to-10.62 D)of the right eye and-2.87±3.35 D(range:+2.75 to-11.12 D)of the left eye.The average duration of diplopia in the case group was 29.83±35.72mo,of which 80 patients(96.39%)were primarily with distance diplopia.The near and distance esotropia angle after wearing glasses were 52.36±20.95 prism degree(PD)and 56.71±19.54 PD,respectively,and there was no statistically significant difference between the two(t=1.38,P=0.169).The incidence of improper glasses wearing and unhealthy eye habits in the case group was significantly higher than those in the control group(P<0.05).Close-up work without glasses[β=2.30,odds ratio(OR)=10,95%confidence interval(CI)2.35-42.51,P=0.002]and near work in supine position(β=1.80,OR=6.02,95%CI 3.29-11.02,P<0.001)were independent risk factors for AACE.CONCLUSION:Patients with AACE mainly present with distance diplopia,and there is a high degree of variation in myopia.Near work without wearing glasses and in supine position are independent risk factors for AACE.

A case of unusual acquired factor V deficiency

Dear editor,Factor V deficiency is a rare bleeding disorder,which includes congenital and acquired factor V deficiencies.Congenital factor V deficiency(CFVD)is an autosomal recessive disorder with an estimated prevalence of 1:1,000,000.[1]However,acquired factor V deficiency(AFVD)is even rarer.

Acquired immunity and Alzheimer's disease

Alzheimer’s disease(AD) is an age-related neurodegenerative disease characterized by progressive cognitive defects. The role of the central immune system dominated by microglia in the progression of AD has been extensively investigated. However, little is known about the peripheral immune system in AD pathogenesis.Recently, with the discovery of the meningeal lymphatic vessels and glymphatic system, the roles of the acquired immunity in the maintenance of central homeostasis and neurodegenerative diseases have attracted an increasing attention. The T cells not only regulate the function of neurons, astrocytes, microglia, oligodendrocytes and brain microvascular endothelial cells, but also participate in the clearance of β-amyloid(Aβ) plaques. Apart from producing antibodies to bind Aβ peptides, the B cells affect Aβ-related cascades via a variety of antibodyindependent mechanisms. This review systemically summarizes the recent progress in understanding pathophysiological roles of the T cells and B cells in AD.

Acquired haemophilia as a complicating factor in treatment of nonmuscle invasive bladder cancer:A case report

BACKGROUND Acquired haemophilia(AH)is a serious autoimmune haematological disease caused by the production of auto-antibodies against coagulation factor VIII.In some patients,AH is associated with a concomitant malignancy.In case of surgical intervention,AH poses a high risk of life-threatening bleeding.CASE SUMMARY A 60-year-old female patient with multiple recurrences of non-muscle invasive bladder cancer underwent transurethral tumour resection.A severe haematuria developed postoperatively warranting two endoscopic revisions;however,no clear source of bleeding was identified in the bladder.Subsequent haematological examination established a diagnosis of AH.Treatment with factor VIII inhibitor bypass activity and immunosuppressive therapy was initiated immediately.The patient responded well to the therapy and was discharged from the hospital 21 d after the primary surgery.At the 38-mo follow-up,both AH and bladder cancer remained in complete remission.CONCLUSION AH is a rare,life-threatening haematological disease.AH should be considered in patients with persistent severe haematuria or other bleeding symptoms,especially if combined with isolated activated partial thromboplastin time prolongation.

Acute acquired concomitant esotropia with congenital paralytic strabismus:A case report

BACKGROUND An unusual case of acute acquired concomitant esotropia(AACE)with congenital paralytic strabismus in the right eye is reported.CASE SUMMARY A 23-year-old woman presented with complaints of binocular diplopia and esotropia of the right eye lasting 4 years and head tilt to the left since 1 year after birth.The Bielschowsky head tilt test showed right hypertropia on a right head tilt.She did not report any other intracranial pathology.A diagnosis of AACE and right congenital paralytic strabismus was made.Then,she underwent medial rectus muscle recession and lateral rectus muscle resection combined with inferior oblique muscle myectomy in the right eye.One day after surgery,the patient reported that she had no diplopia at either distance or near fixation and was found to be orthophoric in the primary position;furthermore,her head posture immediately and markedly improved.CONCLUSION In future clinical work,in cases of AACE combined with other types of strabismus,we can perform conventional single surgery for both at the same time,and the two types of strabismus can be solved simultaneously.

Evolution of Acquired Humoral Immunity after Full Vaccination against SARS-CoV-2. IgG Levels in Healthcare Workers at 6 and 9 Months

Background: The COVID-19 pandemic continues to be a major worldwide health problem. The present study aims to contribute to surveillance of the immune and clinical response of vaccines to SARS-CoV-2. Methods: Observational medication study on acquired immunity and effectiveness of vaccines. Population: 620 workers in the health service of Almansa (Spain). Representative sample of 150 individuals. Sociodemographic, clinical, and epidemiological data and samples were recorded to determine anti-SARS-CoV-2 serum IgG levels 6 and 9 months after vaccination with Pfizer. Results: Mean age 46.45 years;76% women;85.1% working in a hospital. 19.3% had had COVID-19 in the year prior to vaccination. 96.7% were fully vaccinated with Pfizer/BioNTech. At 6 months, 100% seropositivity and mean IgG levels of 3017.2 AU/ml. Significant variations in IgG levels in individuals with prior COVID-19 infection and smokers. At 9 months, 99.3% remained seropositive;2.8% infected after vaccination. The repeated measures analysis showed a difference in means of 669.0 AU/ml (significant decrease in IgG levels of 28.9%). Conclusion: Antibody levels remained positive 6 and 9 months after vaccination, although IgG levels were found to decay.

Biomedical application of materials for external auditory canal: History,challenges, and clinical prospects

Biomaterials play an integral role in treatment of external auditory canal (EAC) diseases. Regarding the specialanatomic structure and physiological characteristics of EAC, careful selection of applicable biomaterials wasessential step towards effective management of EAC conditions. The bioactive materials can provide reasonablebiocompatibility, reduce risk of host pro-inflammatory response and immune rejection, and promote the healingprocess. In therapeutic procedure, biomaterials were employed for covering or packing the wound, protection ofthe damaged tissue, and maintaining of normal structures and functions of the EAC. Therefore, understandingand application of biomaterials was key to obtaining great rehabilitation in therapy of EAC diseases. In clinicalpractice, biomaterials were recognized as an important part in the treatment of different EAC diseases. Thechoice of biomaterials was distinct according to the requirements of various diseases. As a result, awareness ofproperty regarding different biomaterials was fundamental for appropriate selection of therapeutic substances indifferent EAC diseases. In this review, we firstly introduced the characteristics of EAC structures and physiology,and EAC pathologies were summarized secondarily. From the viewpoint of biomaterials, the different materialsapplied to individual diseases were outlined in categories. Besides, the underlying future of therapeutic EACbiomaterials was discussed.

Immediate secondary rhinoplasty using a folded dermofat graft for resolving complications related to silicone implants: A case report

BACKGROUND Various surgical techniques have been developed to enhance the nose shapes of Asian patients.Silicone implant augmentation rhinoplasty is widely used because it is relatively easy to perform and often yields satisfactory outcomes.However,this technique may lead to complications,including ischemia,necrosis,and over-augmentation.The most appropriate management of these complications,including infection,is immediate implant removal and revision surgery once the accompanying inflammation has healed.Occasionally,the patient may experience distress from nasal deformities during the intervention period.CASE SUMMARY Herein,we describe the case of a patient who underwent a secondary dorsal augmentation,with a folded dermofat graft harvested from the inguinal area and simultaneous implant removal,successfully preventing dimpling of the nasal deformity.CONCLUSION This surgical method can effectively manage implant-related complications following augmentation rhinoplasty using a silicone implant and provide satis-factory patient outcomes.

Steroids in acute respiratory distress syndrome:A panacea or still a puzzle?

Acute respiratory distress syndrome(ARDS)is a unique entity marked by various etiologies and heterogenous pathophysiologies.There remain concerns regarding the efficacy of particular medications for each severity level apart from respiratory support.Among several pharmacotherapies which have been examined in the treatment of ARDS,corticosteroids,in particular,have demonstrated potential for improving the resolution of ARDS.Nevertheless,it is imperative to consider the potential adverse effects of hyperglycemia,susceptibility to hospital-acquired infections,and the development of intensive care unit acquired weakness when administering corticosteroids.Thus far,a multitude of trials spanning several decades have investigated the role of corticosteroids in ARDS.Further stringent trials are necessary to identify particular subgroups before implementing corticosteroids more widely in the treatment of ARDS.This review article provides a concise overview of the most recent evidence regarding the role and impact of corticosteroids in the management of ARDS.

Chinese Philosophical Epistemology and Its Defects

The“University”proposes the proposition of“investigating things to acquire knowledge”,presenting the rudimentary form of Chinese philosophical epistemology.Over the following 2,500 years,it has undergone numerous debates on the relationship between knowledge and action;however,no philosopher has developed a comprehensive epistemological system that explores the nature,source,formation,application,truth,testing,structure of human knowledge,as well as the relationship between language and thinking.The concept of“know”in the philosophy of“investigating things to attain knowledge”is equivalent to concepts such as“idea”and“meaning”in Western philosophy.However,the cognitive state of“know”has not been fully explored and expanded upon,nor has the distinction between empirical and rational recognition of“know”been made.Confucianism advocated the“learning”of language communication as one of the ways to acquire knowledge,but it failed to evolve a method of using language to conduct formal logical reasoning to acquire knowledge and test truth.The“eight trigrams”deduction and yin-yang and five elements theory in the“I Ching”have stifled the emergence of modern scientific epistemological methods in China in terms of thinking mode.Confucian epistemology:focuses on“reason”and interpersonal relationships,with an emphasis on the establishment of moral ethics and social order.Taoist epistemology:pursues a realm beyond experience and social conventions,understanding the world through introspection and insight;it focuses on grasping“Tao”,providing vague guidance for determining universal truths and acquiring precise knowledge;it is prone to falling into the dilemma of nihilism and relativism.The concept of unity between heaven and man and unity between knowledge and action has led to the lack of differentiation in Chinese philosophical epistemology regarding the study of the relationship between subject and object,not involving the way in which the subject understands the object,the limitations of understanding,and the interaction between subject and object in the process of understanding.

Factors Associated with Antiretroviral Therapy Defaulting among Adult Patients Receiving Care at Chikankata Mission Hospital, Chikankata District, Zambia

Background: Defaulting on antiretroviral therapy has been identified as the most important factor contributing to the antiretroviral therapy failure rate. This study aimed to investigate factors associated with defaulting on antiretroviral therapy among adult patients receiving care at Chikankata Mission Hospital antiretroviral therapy clinic. Method: Cross-sectional analytical study on 385 participants selected by a computer generated random numbers technique of simple random sampling from among the patients receiving antiretroviral therapy at Chikankata Mission Hospital. Data collected were processed and analysed using Statistical Package for Social Science version 27. Univariate and backward multivariable logistic regression analysis was performed to identify factors associated with antiretroviral therapy defaulting. The level of significance was set at 5% with a confidence level of 95%. Results: Over half (58.4%) of the study participants defaulted on antiretroviral therapy. About 65.8% of study participants indicated improved health as the reason they defaulted on antiretroviral therapy. Most participants indicated that it was important to always go for antiretroviral therapy services (Adjusted Odds Ratio 1.95;95% Confidence Interval: [1.14 - 3.33], p = 0.015). Very few participants indicated poor family support for antiretroviral therapy services (Adjusted Odds Ratio 4.08;95% Confidence Interval: [2.02 - 8.23], p Conclusion: Defaulting on antiretroviral therapy continues to be a significant problem and needs to be addressed as a matter of priority. More counselling and awareness-raising programmes are required to improve knowledge and understanding on the importance of attending scheduled antiretroviral therapy clinics and services as well as the consequences of defaulting on antiretroviral therapy.

Increasing role of post-intensive care syndrome in quality of life of intensive care unit survivors

In this editorial we comment on the detrimental consequences that post-intensive care syndrome(PICS)has in the quality of life of intensive care unit(ICU)survivors,highlighting the importance of early onset of multidisciplinary rehabilitation from within the ICU.Although,the syndrome was identified and well described early in 2012,more awareness has been raised on the long-term PICS related health problems by the increased number of coronavirus disease 2019 ICU survivors.It is well outlined that the syndrome affects both the patient and the family and is described as the appearance or worsening of impairment in physical,cognitive,or mental health as consequence of critical illness.PICS was described in order:(1)To raise awareness among clinicians,researchers,even the society;(2)to highlight the need for a multilevel screening of these patients that starts from within the ICU and continues after discharge;(3)to present preventive strategies;and(4)to offer guidelines in terms of rehabilitation.An early multidisci-plinary approach is the key element form minimizing the incidence of PICS and its consequences in health related quality of life of both survivors and their families.

Acquired amegakaryocytic thrombocytopenia previously diagnosed as idiopathic thrombocytopenic purpura in a patient with hepatitis C virus infection

We report the first case of a patient with hepatitis C virus(HCV) infection and idiopathic thrombocytopenic purpura(ITP), who later developed acquired amegakaryocytic thrombocytopenia(AAMT), with autoantibodies to the thrombopoietin(TPO) receptor(c-Mpl). A 64-year-old woman, with chronic hepatitis C, developed severe thrombocytopenia and was diagnosed with ITP. She died of liver failure. Autopsy revealed cirrhosis and liver carcinoma. In the bone marrow, a marked reduction in the number of megakaryocytes was observed, while other cell lineages were preserved. Therefore, she was diagnosed with AAMT. Additionally, autoantibodies to c-Mpl were detected in her serum. Autoantibodies to c-Mpl are one of the causes of AAMT, acting through inhibition of TPO function, megakaryocytic maturation, and platelet formation. HCV infection induces several autoantibodies. HCV infection might also induce autoantibodies to c-Mpl, resulting in the development of AAMT. This mechanism may be one of the causes of thrombocytopenia in patients with HCV infection.