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증례 : 신장 ; 빠른 체중 감량 후 발생된 급성 신정맥 혈전증과 폐 혈전색전증
김세란 ( Sei Rhan Kim ),이민정 ( Min Jeong Lee ),곽지영 ( Ji Yeong Kwak ),이승경 ( Seung Kyung Lee ),신규태 ( Gyu Tae Shin ),김흥수 ( Heung Soo Kim ),박인휘 ( In Whee Park ) 대한내과학회 2012 대한내과학회지 Vol.83 No.4
Renal vein thrombosis (RVT) is rare and primarily observed in children with severe dehydration or in adults in a hypercoagulable state. This diagnosis is rarely considered when it occurs in adults. We report a case of a young man who had weight loss of 8 kg in 2 weeks accompanied by dehydration with excessive exercise, and he developed a right RVT with a pulmonary thromboembolism. The man had a 3-year history of essential hypertension and was admitted to the hospital because of severe right-flank pain. A RVT and pulmonary thromboemboli were visualized by computed tomography. No abnormal results were observed on coagulation tests, and no evidence of malignancy was found. We concluded that the RVT and pulmonary thromboembolism were induced by dehydration. Even though the patient was an adult, rapid weight loss with dehydration may cause RVT and unusual thromboembolic events must be suspected to avoid a delay in the diagnosis. (Korean J Med 2012;83:510-513)
신정숙 ( Jeoung Sook Shin ),김기찬 ( Ki Chan Kim ),김동훈 ( Dong Hoon Kim ),김세란 ( Sei Rhan Kim ),박진주 ( Jin Ju Park ),신준한 ( Joon Han Shin ),황교승 ( Gyo Seung Hwang ) 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.2
J wave syndrome is a deflection with the dome or the hump morphology in the same direction as R wave and immediately followed the QRS complex on the surface ECG. It is known as an abnormalities in the manifestation of the transient outward current (Ito)-mediated J wave. It includes Brugada syndrome, early repolarization syndrome, arrhythmia associated hypothermia and the ST-segment elevation myocardial infarction. Several lines of evidence have suggested that J wave syndrome closely associated with idiopathic Ventricular tachycardia (VT) and Ventricular fibrillation (VF). We report one case of J wave syndrome in a 50 years old male who was a survivor of sudden cardiac death. He had suffered 2 times sudden cardiac death previously. At the visiting day, his electrocardiography (ECG) exhibited J waves in precordial leads (V1-V6), II, II, aVF and J-ST elevation at the same leads. Considering, recurrent sudden cardiac arrest, J wave on inferior, lateral lead on ECG, we conclude he has a J wave syndrome.
혈청양성 류마티스관절염 환자에서 급성 신부전을 동반한 다발성 골수종
이승경 ( Seung Kyung Lee ),황선혁 ( Sun Hyuk Hwang ),박주한 ( Joo Han Park ),송가원 ( Ga Won Song ),박선영 ( Sun Young Park ),김세란 ( Sei Rhan Kim ),정주양 ( Ju Yang Jung ),배창범 ( Chang Bum Bae ),김현아 ( Hyoun Ah Kim ),정성현 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.5
It is known that rheumatoid arthritis (RA) patients show increased incidence of multiple myeloma (MM), despite its rarity. Only one case of MM with seronegative RA was reported in Korea, thus far. We report a case of MM with seropositive RA. The patient was a 66 year old female who had been diagnosed with seropositive RA 4 years ago. Over the last 1 month, the patient experienced general weakness and weight loss of 10 kg. It was found that her serum creatinine had increased and her urine analysis showed proteinuria. To evaluate renal failure and proteinuria, renal biopsy, bone marrow biopsy and electrophoresis were carried out. A diagnosis of myeloma cast nephropathy was made. We report this rare case of MM represented as acute renal failure during the treatment for RA, and include a review of the literature.