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콩팥 증후군과 혈액 응고인자 X 결핍을 보인 일차성 아밀로이드증
김민영 ( Min Young Kim ),곽수영 ( Soo Yeong Kwak ),김경희 ( Kyung Hee Kim ),이지인 ( Ji In Lee ),하영은 ( Young Eun Ha ),김대중 ( Dae Joong Kim ),오하영 ( Ha Young Oh ),이정은 ( Jung Eun Lee ),허우성 ( Woo Seong Huh ),김윤구 ( Yoo 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.1
We report a case of nephrotic syndrome and factor X deficiency secondary to primary amyloidosis. A 58-year-old man was referred to our hospital for evaluation of nephrotic syndrome and bleeding tendency. He was confirmed to have primary amyloidosis by renal biopsy, immunofixation electrophoresis and bone marrow findings. His bleeding tendency was due to prothrombin time prolongation caused by isolated factor X deficiency. If any patient with nephrotic syndrome has bleeding tendency due to coagulation abnormalities, that patient should be considered to have factor X deficiency secondary to primary amyloidosis.
Tacrolimus를 근간으로 한 면역억제제를 복용하는 장이식 환자에서 이식 후 새로 발생한 당뇨병의 위험인자
허우성 ( Woo Seong Huh ),최유경 ( Yu Kyong Choi ),김예지 ( Ye Jee Kim ),최남경 ( Nam Kyong Choi ),김민영 ( Min Young Kim ),백나나 ( Na Na Baek ),염지연 ( Ji Youn Youm ),이정은 ( Jung Eun Lee ),김대중 ( Dae Joong Kim ),김윤구 ( Yoo 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.6
Purpose: This study was conducted to identify risk factors for new onset diabetes after transplantation (NODAT) among renal transplant recipients treated with tacrolimus-based immunosuppressant. Methods: We selected renal transplant recipients who underwent surgery at Samsung Seoul Hospital between May 2001 and July 2009. Exclusion criteria were as follows: recipients <18 years old, history of diabetes mellitus (DM) or impaired glucose tolerance. Analysis of possible risk factors for NODAT included age, gender, body mass index, co-morbid diseases, family history of DM, infection of hepatitis B or polyomavirus, type of donors (cadaver or living) and acute rejection. Overall incidence and median value of NODAT onset day were analyzed with Kaplan-Meier curve. We calculated crude incidence rate and relative risk (RR) and 95% confidence interval (CI) for independent risk factors of NODAT using Cox proportional hazard analysis. Results: A total of 278 patients were included and the incidence of NODAT was 13.3% (5.6/100 person-year) and the median duration of NODAT onset was 28 days. In Cox analysis, risk factors for NODAT were age (45-59 years: RR=1.41, 95% CI 1.09-1.83, 60> years: RR=4.36, 95% CI 2.00-9.49), family history of DM (RR=1.62, 95% CI 1.12-2.34) and polyomavirus infection (RR=1.40, 95% CI 1.08-1.81). Conclusion: The risk factors for NODAT among renal transplant recipients treated with tacrolimus- based regimen were age (>45 years old), family history of DM and polyomavirus infection.