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황용 ( Yong Hwang ),이상헌 ( Sang Heon Lee ),홍성철 ( Sung Chul Hong ),김도영 ( Do Young Kim ),김용진 ( Yong Jin Kim ),서정웅 ( Jung Woong Seo ),손인성 ( In Sung Son ),정현아 ( Hyun A Jung ),최홍석 ( Hong Seok Choi ),이정화 ( Jun 대한류마티스학회 2012 대한류마티스학회지 Vol.19 No.4
Giant cell arteritis (GCA), the most common form of systemic vasculitis in adults, preferentially involves large and medium-sized arteries in patients over the age of 50. The classic manifestations are headaches, jaw claudication, polymyalgia rheumatica, and visual symptoms. Acute myeloid leukemia (AML) is a hematopoietic stem cell disorder characterized by a block in the differentiation of hematopoiesis, resulting in the growth of a clonal population of neoplastic cells or blasts. This malignant alteration in hematopoietic stem cells leads to a loss of normal hematopoietic function, which, if left untreated, typically leads to death within weeks to months of its clinical presentation. Although there have been reports of CLL or CML accompanied by several kinds of autoimmune vascular diseases, such as polymyalgia rheumatica, GCA, or necrotizing temporal arteritis, no studies have reported a case of AML with GCA. We experienced an 80-year-old male patient who developed AML 6 years after the diagnosis of GCA. He was under the use of oral glucocorticoid, hydroxychloroquine, and methotrexate at the time of the diagnosis of the AML. This is the first case in Korea to report GCA accompanied by AML.
펜타미딘으로 치료 받은 후천성 면역 결핍증 환자에서 발생한 저혈당 1예
송기호 ( Kee Ho Song ),황용 ( Yong Hwang ),최홍석 ( Hong Seok Choi ),기현균 ( Hyun Kyun Ki ),정혜숙 ( Hae Suk Cheong ),서정웅 ( Jung Woong Seo ),정현아 ( Hyun Ah Chung ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
Trimethoprim-sulfamethoxazole (TMX-SMZ) is the initial treatment for Pneumocystis jiroveci pneumonia in human immunodeficiency virus (HIV) patients. About 20% of patients do not complete the TMX-SMZ treatment due to treatment failure or adverse reactions. Pentamidine isethionate has been used for P. jiroveci pneumonia as a second-line regimen. Although hypoglycemia is a common adverse effect of pentamidine, pentamidine-induced hypoglycemia has not been reported in Korea. We present an HIV patient with grand mal seizures caused by pentamidine-induced hypoglycemia who was managed successfully with IV dextrose infusion. Mental changes can occur during pentamidine treatment, but hypoglycemia is often ignored and misdiagnosed as epilepsy or stroke. It can result in seizures, coma, and even death. We should be aware of pentamidine-induced hypoglycemia, which can lead to severe neurologic deficits and diabetes mellitus. (Korean J Med 2012;83:679-682)