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이혜원,강진두,여창우,윤성운,이광재,최문기 대한의학회 2016 Journal of Korean medical science Vol.31 No.8
Wilson’s disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson’s disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson’s disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson’s disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
윤성운,여창우,강진두,이혜원,김수형,김병수 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
HIV-associated myocarditis is defined as inflammation and damage of the myocardium due to HIV infection. Its disease progression vary, as it may be asymptomatic or manifest as dilated cardiomyopathy,heart failure A 28-year-old male presented cough that persisted for 6 months and aggravating dyspnea. Chest x-ray showed cardiomegaly and pulmonary edema. Laboratory tests revealed CK-MB 0.6 ug/L, Troponin I 0.21 ng/mL, and proBNP of 11,072 pg/mL. Echocardiography showed findings of dilated cardiomyopathy with dilated atrium, ventricles and severe left ventricular systolic dysfunction. Chest CT showed multiple ground-glass opacities. Anti-HIV Ab (ELISA) was performed, considering pneumocystis pneumonia associated with AIDS. ELISA and Western blot results were positive, HIV RNA was 122,000 copies/mL, CD4+ lymphocytes were 27 cells/mL. The patient was diagnosed as dilated cardiomyopathy due to HIV-associated myocarditis. He afterwards complained of decreased visual acuity and was diagnosed as cytomegalovirus (CMV) retinitis.
용량 보정 후 투여한 이소니아지드에 의해 노인에서 발생한 경련과 산증1례
신영신,심은희,여창우,강진두,김지연,박선자 고신대학교(의대) 고신대학교 의과대학 학술지 2014 고신대학교 의과대학 학술지 Vol.29 No.1
Isoniazid is one of the most commonly used antituberculosis drug. Acute into xication is characterized by repetitious convulsions, high anion gap metabolic a cidosis and coma. The basis of theraphy consists of parental pyridoxine admi nistration in a dose equivalent to that of isoniazid ingested. Here we present a case of seizure and metabolic acidosis due to only renal adjustment dosage of Isoniazid in an elderly woman.
심은희,신영신,박민규,여창우,강진두,윤성운,이광재 대한노인병학회 2013 Annals of geriatric medicine and research Vol.17 No.3
Renal tubular acidosis (RTA) is a metabolic acidosis caused by impaired excretion of hydrogen ions or reabsorption of bicarbonate. Disorders caused by impairment of bicarbonate reabsorption in the proximal tubule are classified as proximal RTA, whereas those resulting from impairment of hydrogen ion secretion at the distal tubule are called distal RTA. The most common causes of distal renal tubular acidosis in adults are autoimmune disorders including Sjögren syndrome, systemic lupus erythematosis, rheumatoid arthritis, and autoimmune thyroiditis. Of the thyroiditis states, Graves’ disease-associated RTA is a rare disease. We experienced and managed one case of hypokalemic muscle weakness asso- ciated with Graves’ disease and distal renal tubular acidosis.
저용량 경구용 갑상선 호르몬제로 치료한 점액수종 혼수 1예
박민규,이광재,이혜원,심은희,강진두,여창우 대한노인병학회 2013 Annals of geriatric medicine and research Vol.17 No.4
Myxedema coma is a severe life-threatening form of hypothyroidism that is associated with a high mortality rate. It is known to be common in the elderly, and is mainly accompanied with cardiogenic shock, respiratory failure, central nervous system dysfunction, and body temperature regulation defects. Thus, immediate management is required in order to prevent fatal complications in myxedema coma. However, early detection is difficult and further, it is easily misdiagnosed due to its low incidence rate and nonspecific symptoms. We report a case of myxedema coma which was misdiagnosed for heart failure. The patient was successfully treated with intensive care and oral low dose levothyroxine.
증례 : 신장 ; 신이식 환자에서 성공적으로 치료된 BK 바이러스 관련 출혈성 방광염
박시형 ( Sihyung Park ),이가희 ( Ga Hee Lee ),박봉수 ( Bong Soo Park ),진규복 ( Kubok Jin ),박진한 ( Jin Han Park ),강진두 ( Jin Du Kang ),김양욱 ( Yang Wook Kim ) 대한내과학회 2015 대한내과학회지 Vol.89 No.6
Hemorrhagic cystitis is defined as diffuse mucosal inflammation of the urinary bladder that presents with gross hematuria. A variety of factors, including chemotherapeutic agents, radiation therapy and infection, can cause hemorrhagic cystitis. Among them, BK virus-associated hemorrhagic cystitis is common in patients who have undergone stem cell transplantation but relatively rare in kidney transplantation patients. Here, we present the case of a kidney-transplant patient with BK virus-associated hemorrhagic cystitis and interstitial nephritis who was successfully treated with leflunomide and ciprofloxacin. (Korean J Med 2015;89:704-708)