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유선진 ( Sun Jin You ),박준성 ( Joon Sung Park ),김지현 ( Jee Hyun Kim ),박수경 ( Su Kyoung Park ),배상철 ( Sang Cheol Bae ),김근호 ( Gheun Ho Kim ),강종명 ( Chong Myung Kang ),박문향 ( Moon Hyang Park ),이창화 ( Chang Hwa Lee 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5
Purpose: Clinical treatment for lupus nephritis largely depends upon histological renal biopsy classification. But it has been reported that serologic biochemical markers are not strongly associated with pathologic classification. The aim of this study is to see whether serologic markers could predict pathologic class of lupus nephritis for appropriate treatment. Methods: We investigated 67 patients, who underwent renal biopsy with lupus nephritis at Hanyang University Hospital between January, 2005 and August, 2007. Biological markers for this study are hematuria, proteinuria, serologic data of lupus activity and azotemia. They were retrospectively analyzed from patients grouped by ISN/RPS 2003 lupus nephritis classification. Results: Total 67 patients (men 5, women 62) were enrolled and the mean age of the patients was 30.6±9 years. The number of patient group by pathologic classification was 4 cases for class II, 15 cases for class III, 30 cases for class IV and 15 cases for class V. Spot urine protein to creatinine ratio more than 3 increased in class IV group statistically (p=.007). C3 level decreased more in class IV group than class III, V groups. Ten patients showed azotemia, and 9 of them were class IV group (p=.048). Conclusion: The patients with more increased proteinuria, decreased C3 level and azotemia showed more frequently in class IV group. Hence those three biological markers may be a clinical clue to pathologic diagnosis.
혈장교환술과 면역억제제 치료로 호전된 항사구체기저막 항체질환
김지현 ( Jee Hyun Kim ),유선진 ( Sun Jin You ),박준성 ( Jun Sung Park ),이창화 ( Chang Hwa Lee ),김근호 ( Gheun Ho Kim ),강종명 ( Chong Myung Kang ),임소덕 ( So Dug Lim ),이종호 ( Jong Ho Lee ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.3
Anti-glomerular basement membrane disease is a rare autoimmune disease characterized by rapidly progressive renal failure and/or pulmonary hemorrhage. The presence of severe crescentic glomerular inflammation with linear deposition of immunoglobulin G along the glomerular basement membrane is pathognomonic. Because renal function is rapidly and often irretrievably destroyed, many patients require hemodialysis all through their lifetime. We report a case of 33 year(s)-old man who was diagnosed as anti-glomerular basement membrane disease without pulmonary hemorrhage. The patient was treated with pulse methylprednisolone and plasmapheresis followed by oral corticosteroid and cyclophosphamide. His renal function was successfully recovered with early diagnosis and aggressive treatment.
전신성 홍반성 루푸스 신염 활성도와 소변 Transforming Growth Factor-β Induced Gene-h3 (βig-h3)의 연관성
김일 ( Il Kim ),홍철호 ( Cheol Ho Hong ),조현석 ( Hyun Seok Cho ),유선진 ( Sun Jin You ),백창희 ( Chang Hee Paik ),이혜순 ( Hye Soon Lee ),엄완식 ( Wan Sik Uhm ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),유대현 ( Dae Hyun Yo 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.4
Background: TGF-β-induced gene-h3 (βig-h3) is a novel gene induced by active TGF-β and the association with other renal disease is reported. Lupus nephritis is characterized by excessive extracelluar matrix accumulation and the implication that TGF-β is increased in lupus nephritis is known. We measured the urinary βig-h3 in lupus nephritis and sought its association with the activity of lupus nephritis through renal biopsy. The objective of this study was to examine urinary βig-h3 excretion in lupus nephritis and the association with activity of lupus nephritis. Methods: Fifteen patients (median age 32.6±2.9 years, range 18∼64) who developed lupus nephritis underwent renal biopsy. At the time of biopsy, they showed significant proteinuria. Total urinary βig-h3 concentration was assayed by enzyme-linked immunoabsorbent assay and expressed as a ratio to urinary creatinine concentration. Results: There were correlations between urinary βig-h3 and the reduction of C3 (r=-0.566, p=0.028<0.05), the magnitude of proteinuria (r=0.531, p=0.042<0.05). The Activity Index, Chronicity Index in the renal biopsy, C4, anti-dsDNA Ab titer were not significantly correlated with urinary βig-h3 excretion, but the patients with high Activity Index had the increased level of urinary βig-h3. Five patients who had fibrinoid necrosis in renal biopsy showed higher level of urinary βig-h3 than the others (107.78±43.02 vs. 50.21±10.12 ng/ml, p=0.061) Conclusion: In this study, There is some correlation between urinary βig-h3 and the activity of lupus nephritis. Urinary βig-h3 may play a role in predicting the active lupus nephritis. A further study is needed in large population and in situ expression of βig-h3.