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깊은 정맥혈전증이 합병된 이식신의 신대체 지방종증 1예
이상철 ( Sang Choel Lee ),김윤지 ( Yoon Ji Kim ),이상헌 ( Sang Hun Lee ),박형복 ( Hyung Bok Park ),현여경 ( Yu Kyung Hyun ),동시헌 ( Shi Heon Dong ),윤수영 ( Soo Yong Yoon ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.6
Purpose: Replacement lipomatosis of the kidney is a rare disorder in which a massive fatty tissue proliferation occurs within the renal sinus, hilum and perirenal region. Clinical symptoms includes flank pain, hematuria, fever usually associated with urinary tract infection and renal stone. But deep vein thrombosis due to mass effect has not been reported to be associated with replacement lipomatosis of kidney. A 37-year-old male was referred for the initiation of hemodialysis due to chronic rejection of allograft kidney. Collateral superficial veins were observed on his anterior abdominal wall and firm mass was palpable in the right lower quadrant abdomen. Abdominal-pelvis computed tomography revealed huge fatty mass originated from allograft kidney and non-visualization of inferior vena cava with lower density thrombus at both the common femoral veins. We report a rare case of replacement lipomatosis of the kidney complicated by deep vein thrombosis after renal transplantation.
Infliximab으로 치료한 류마티스관절염 환자에서 발생한 결핵성 복막염 1예
이상헌 ( Sang Hun Lee ),김인태 ( In Tae Kim ),최상태 ( Sang Tae Choi ),김윤지 ( Yun Ji Kim ),송정수 ( Jung Soo Song ),이용원 ( Yong Won Lee ),박형복 ( Hyung Bok Park ),현여경 ( Yu Kyung Hyun ) 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.4
저자들은 류마티스관절염에서 infliximab 치료 후에 결핵성 복막염이 발생한 57세 여자 환자를 진단하고 치료한 경험을 하였기에 이를 보고하는 바이다. 류마티스관절염에서 결핵성 복막염이 의심될 때, 단클론항체 형태의 TNF-α 길항제 사용, 고령, 1년 미만의 사용 기간, 풍토성 지역의 거주, 동반된 전신 질환 등의 위험 인자를 고려하는 것은 질병을 빨리 진단하고 치료하는 데에 도움이 될 수 있다. One of the severe adverse reactions to anti-tumor necrosis factor (TNF)-α therapy is the reactivation of tuberculosis. We present a case of tuberculous peritonitis in a 57-year-old woman with rheumatoid arthritis (RA) that appeared during treatment with infliximab. Confirming a diagnosis of tuberculous peritonitis is difficult and can be delayed because of the nonspecific symptoms, the rarity of the disease, and the low detection rate of mycobacteria in ascites fluid. This case illustrates that prompt anti-tuberculous therapy is needed for suspected cases of tuberculous peritonitis in RA patients treated with infliximab.