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증례 : C형 간염 환자의 페그인터페론과 리바비린 병합요법 중 발생한 항CCP항체 양성 류마티스 관절염 1예
김동현 ( Dong Hyun Kim ),김영환 ( Young Hwan Kim ),이순일 ( Soon Ii Lee ),하병길 ( Byung Kil Ha ),최성호 ( Sung Ho Choi ),김성일 ( Sung Ii Kim ),이정욱 ( Joung Wook Lee ) 대한내과학회 2012 대한내과학회지 Vol.83 No.2
만성 C형 간염으로 페그인터페론과 리바비린 병합 치료시작 16주 후 다발성 관절통이 발생하여, 류마티스관절염 진단하에 NSAID와 DMARD를 투약하여 호전된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Combination therapy with pegylated interferon (IFN) and ribavirin is the mainstay of treatment for chronic hepatitis C. An important side effect of IFN is the induction of an autoimmune disease such as autoimmune thyroid disease or, rarely, rheumatoid arthritis. However, the introduction of pegylated formulations of IFN can minimize the risk of autoimmune induction by reducing immunogenicity. Detection of anti-cyclic citrullinated peptide (anti-CCP) antibodies can help distinguish rheumatoid arthritis from hepatitis C-related arthritis. Here, we report the first Korean case of a 48-year-old female who developed anti-CCP antibody-positive rheumatoid arthritis following peginterferon alpha-2a therapy for hepatitis C.
반복되는 복통으로 진단된 호산구성 위장관염에 동반된 호산구성 복수와 방광염 1예
이순일,박희승,하병길,김동현,유진택,최성호 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.2
Eosinophilic gastroenteritis is a relatively uncommondisease of unknown etiology and pathogensis. It is characterized by massive tissue eosinophilia, that can involve any layers of the gastrointestinal tract wall. The gastrointestinal signs and symptoms usually reflect the layer which is most severly affected. Eosinophilic gastroenteritis can be rarely accompanied by extraintestinal involvement. We report a case of a 19-year-old male with repeated epigastric and low abdominal pain. An abdominal computed tomography showed diffused wall thickeningof esophagus, small bowel and bladder with ascites. Esosinophilic infiltration was shown by multiple biopsies of the esophagus, duodenum on esophagogastroduodenoscopy and peritoneal fluid analysis. The patient was diagnosed with eosinophilic gastroenteritis, accompanied by esosinophilic ascites and cystitis and was treated with corticosteroid and ketotifen. Abdominal pain was improved dramatically.
박종화,이경우,김동현,이순일,하병길,신성훈 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.2
A 84-year-old woman visited by back and pubic pain. Abdominal CT showed 10cm sized abdominal mass with calcified component. At bone scan, multiple bone absorption was seen. T2 weighted MRI revealed heterogeneous high signal mass on pubis. Aspiration cytology reported only blood and exudate without malignant cells. Other 88-year-woman visited by systemic arthralgia and dysbasia. Abdominal CT revealed pubic bone fracture, surrounded by soft tissue, and relatively low density on lumbar spine. Bone scan showed increased absorption at multiple bone and joints. Enhanced chest CT revealed only consolidation, no malignant component was seen. Aspiration cytology reported degenerative bone tissue without malignant cell. At these cases, mass like lesion was looked like malignant tumors, but final diagnosis was insufficiency fractures. Aware these cases, we emphasize avoid misunderstanding for malignancy, may read to unnecessary and excessive evaluation before making the correct diagnosis, at insufficiency fracture.