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Adult Onset Still`s Disease의 임상적 고찰
홍애라 ( Ae Ra Hong ),송창호 ( Chang Ho Song ),이지수 ( Ji Soo Lee ),마경애 ( Kyung Ae Ma ),박종석 ( Chong Seong Park ),이찬희 ( Chan Hee Lee ),이수근 ( Soo Kon Lee ) 대한류마티스학회 1997 대한류마티스학회지 Vol.4 No.1
Objective: To understand the clinical manifestations and disease course of adult onset Still`s disease (AOSD). Methods: 15 patients of AOSD diagnosed at Severance hospital, Yonsei University College of Medicine were retrospectively analysed in the period of September 1988 to September 1995. Results: There were 3 men and 12 women (male to female ratio of 1:4). Age of disease onset ranged from 17-55 years, and over 86% of the patients were younger than age 40 at disease onset. The prevalence of clinical features were as follows: fever (100%), arthritis (93%), skin rash (93%), sore throat (60%), abnormal liver function (73%), lymphadenopathy (47%), splenomegaly (47%), hepatomegaly (20%), serositis (13%). Fever was the most common initial symptom. Common labaratory features were leukocytosis with neutrophilia (87%), anemia; Hgb<10 g/dL (67%), increased serum ferritin (83%), ESR (87%) and CRP (93%). Serum ferritin was markedly raised at disease onset and correlated with disease activity. In 2 patients, the disease was controlled with NSAID alone, but most of the patients required steroid to control the disease activity. In 6 patients, MTX was added for steroid sparing effect and for steroid resistant arthritis. Most of AOSD patients had intermittent and chronic disease course. Root Joint arthritis and polyarthritis were factors associated with chronicity. Conclusion: The clinical features of AOSD in our study generally resemble previous reports. Serum ferritin was a useful marker of disease activity. Most patients of AOSD had intermittent and chronic disease course. Root joint athritis and polyarticular pattern at disease onset were factors associated with chronicity.
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이진호,김홍수,서유진,이수진,신준한,김도헌,김승정,김명성,마경애,신규태,임현이 대한신장학회 1999 Kidney Research and Clinical Practice Vol.18 No.5
A 25-year-old male presented with mitral insufficiency, perimembranous type of ventricular septal defect, pulmonary edema and renal insufficiency. The initial serum creatinine level was 16.2mg/dl. Blood cultures were positive for Streptococcus viridans and appropriate antibiotic therapy was initiated. Renal biopsy revealed diffuse proliferative glomerulonephritis with crescents involving all of the glomeruli. Even after adequate duration of treatment with antibiotics, surgical therapy, and high dose steroid therapy, renal function did not recover and the patient ended up with continuous ambulatory peritoneal dialysis. We present a case of crescentic glomerulonephritis associated with bacterial endocarditis with a review of the literature.
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