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Hencoch-Schonlein 자반증 환자에서 발생한 단백 상실성 장병증 : 스테로이드 치험 1예
박종원,김은일,김영옥,윤선애,황수은,서정필,방병기,백지연 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.6
Although gastrointestinal manifestations are very common in patients with Henoch-Schonlein purpura, protein losing enteropathy is a rare complication. We here report a case of protein losing enteropathy in a patient with Henoch-Schonlein purpura. A 52-year old woman presented with lower abdominal pain, purpura and edema on lower extremity. Serum albumin was 1.9g/dL and 24 hour urine protein was 4.7g/day. Skin and kidney biopsy revealed leukocytoclastic vasculitis and mesangial proliferative glomerulonephritis consistent with Henoch-Schonlein purpura, respectively. Colonoscopy showed diffuse mucosal erosion at right colon. (99m)Tc-human serum albumin scintigraphy and fecal alpha-1-antitrypsin clearance confirmed protein losing enteropathy. The protein losing enteropathy improved with steroid treatment.
신이식 환자에서 발생한 뇌 Aspergillosis 에서 Liposomal Amphotericin B 와 내시경적 수술을 이용한 성공적인 치료
우영식(Young Sik Woo),김미정(Mi Jung Kim),장재혁(Jae Heuk Jang),황수은(Soo Eun Hwang),정지성(Ji Sung Chung),신미정(Mi Jung Sin),양철우(Chul Woo Yang),김용수(Yong Soo Kim),방병기(Byung Kee Bang),박주현(Joo Hyun Park) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.4
Aspergillosis involving central nervous system is a rare but life-threatening complication in renal transplant recipients. Its mortality rate approaches almost 100% in spite of various therapeutic regimens. We here report a case of successful treatment of brain aspergillosis with liposomal amphotericin B and endoscopic surgery. A 58-year- old renal transplant recipient admitted due to headache which was developed 5 months ago. He received renal transplant 10 years ago. After admission, brain MRI revealed brain abscess on frontal lobe and this was treated with antibiotics and amphotericin B. On 20 th hospital day, endoscopic surgery via intranasal approach was performed and pathologic finding was consistent with aspergillosis. During treatment, his graft function was progressively deteriorated(serum creatinine level 2.27 mg/dL4.1 mg/dL) and amphoterinc B was replaced with ambisome. Thereafter, renal function was improved(serum creatinine 2.0 mg/dL on 46 th hospital day). Second operation was performed on 50 th hospital day to remove remnant pathologic lesion, and ambisome was continously adminstered. The brain MRI which was performed on 70 th hospital day showed much improvement. He was discharged with oral antifungal drug(itraconazole). Our case demonstrates the successful treatment of brain aspergillosis with medial treatment and minimal invasive surgery.
김용수(Yong Soo Kim),방병기(Byung Kee Bang),양철우(Chul Woo Yang),박정희(Jung Hee Park),박주현(Joo Hyun Park),주현중(Hyun Jung Joo),오정환(Jung Hwan Oh),정정(Jung Jung),황수은(Soo Eun Hwang),고기영(Gi Young Ko) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.3
Hepatic cysts are the most common extrarenal manifestations of adult polycystic kidney disease, but the hepatic cyst infection in a patient with polycystic kidney disease is rare. The infection may remain localized or may be followed by acute cholangitis or septicemia. The best management for infected hepatic cyst is drainage in combination with antibiotic therapy. We experienced a case of infected hepatic cyst in a patient with polycystic kidney disease in a 46-year-old man receiving hemodialysis. He presented with fever and abdominal pain and was found to have an infected liver cyst. Treatment with antibiotics and percutaneous drainage of the cyst resulted in clinical improvement. Thus, we report a case of infected hepatic cyst in a patient with polycystic kidney disease with review of the literature.