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증례 : 류마티스 ; 루푸스와 연관된 혈구포식 림프조직구증에서 Etoposide 병합치료 1예
한승완 ( Sung Wan Han ),강규근 ( Kyu Keun Kang ),박소현 ( So Hyun Park ),송지영 ( Ji Young Song ),유웅선 ( Woong Sun Yu ),최정란 ( Jung Ran Choi ),김춘관 ( Choon Kwan Kim ) 대한내과학회 2013 대한내과학회지 Vol.84 No.4
50세 여자 환자를 SLE 연관 HLH로 진단하고, 면역억제치료에도 호전되지 않아 etoposide를 주사 후 호전된 증례 1예를 보고하는 바이다. Hemophagocytic lymphohistiocytosis (HLH) can develop following strong activation of the immune system and the cardinal symptoms are a prolonged fever, hematological abnormalities, hepatosplenomegaly, and hemophagocytosis. HLH can be classified as primary or secondary HLH, associated with infections, malignancy and autoimmune disease. There is no consensus on the primary treatment regimen in systemic lupus erythematosus (SLE)-associated HLH. We experienced a case of SLE-associated HLH in a previously healthy adult. She was initially treated with intravenous immunoglobulin, cyclosporine, and high-dose steroid, but had a poor clinical response. After intravenous etoposide, the patient stabilized and has been followed for 1 year without reactivation of the HLH or SLE. (Korean J Med 2013;84:613-618).
오수연,김나영,윤혁,최윤진,이주엽,박경준,김희진,강규근,오동현,서아영,이재우,신철민,박영수,Jane C Oh,이동호,정현채 대한암예방학회 2013 Journal of cancer prevention Vol.18 No.2
Background: To identify whether first-degree relatives (FDRs) of gastric cancer (GC) patients have increased risk for atrophicgastritis (AG) and intestinal metaplasia (IM) in relation to other risk factors of GC. Methods: The study cohort consisted of 224 pairs of age-sex matched controls and FDRs. AG and IM in the gastric mucosa werescored histologically using the updated Sydney classification. Risk of having AG and IM was studied by comparing FDRs to controls. Impacts of age, H. pylori infection, smoking, dietary and socioeconomic factors on the presence of AG and IM were studied. Results: In multivariate regression analysis, FDRs had adjusted OR of 2.69 (95% CI 1.06-6.80, P=0.037) for antral IM in malepopulation. Adjusted OR for antral AG and IM were 9.28 (95% CI 4.73-18.18, P<0.001) and 7.81 (95% CI 3.72-16.40, P<0.001)for the H. pylori infected subjects in total population. Getting old by 5 years increased the ORs of having AG and IM byapproximately 1.25 fold (P<0.001). Spicy food increased the OR of antral IM by 2.28 fold (95% CI 1.36-3.84, P=0.002). Conclusions: Family history of GC was an independent risk factor for antral IM in male in our study, which could be one reasonfor the increase of gastric cancer in the family member of gastric cancer. It could be an evidence for the necessity of frequentendoscopy in the presence of family history of GC compared to general population in male.