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증례 : 소화기 ; 글루코사민 복용 후 발생한 약물 유발성 자가면역성 간염
권성순 ( Seong Soon Kwon ),위지완 ( Jee Wan Wee ),박정완 ( Jung Wan Park ),윤석윤 ( Seug Yun Yoon ),정승원 ( Soung Won Jeong ),장재영 ( Jae Young Jang ),진윤미 ( Yoon Mi Jin ) 대한내과학회 2013 대한내과학회지 Vol.85 No.5
글루코사민은 흔하게 사용되며 각광받는 건강 보조식품 중 하나로 항산화 효과 등이 보고되어 있으나 독성, 특히 간염에 대해서는 아직 잘 알려지지 않았다. 저자들은 글루코사민 섭취 후 간독성이 발생한 67세 여자 환자를 경험하였다. 상기 식품을 한 달 이상 섭취 후 약제 유발성 급성 자가면역 간염이 발생하였으며 간손상이 발생할 만한 다른 원인은 관찰되지 않았다. 12주간의 보존적인 치료와 자가면역 간염에 대한 치료(prednisolone과 azathioprine의 병합요법) 후 증상과 생화학적 이상 소견이 호전되었다. Herbal remedies and health foods are widely used, and their side effects have been reported. Glucosamine is a naturally occurring amino-monosaccharide and a safe health food; rarely, however, it can cause cholestatic and hepatocellular hepatitis. We describe a case of drug-induced autoimmune hepatitis after ingestion of glucosamine. A middle-aged woman who had no history of liver disease complained of jaundice after taking glucosamine. The diagnosis of drug-induced acute autoimmune hepatitis was made using the Roussel Uclaf Causality Assessment Method score based on the patient`s history and laboratory data, and percutaneous liver biopsy. After supportive care and administering prednisolone and azathiprine, the patient showed rapid improvement in clinical symptoms and laboratory findings. (Korean J Med 2013;85:503-506)
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혈액투석을 받는 말기신질환 환자에서 말초혈액의 호산구증가증
김경하,장태익,윤석윤,이민영,이남수,원종호,장명희 순천향대학교 순천향의학연구소 2021 Journal of Soonchunhyang Medical Science Vol.27 No.2
Objective Eosinophilia in patients on hemodialysis has already been reported. It has been associated with allergy to dialyzers and exaggerated activation of complement during hemodialysis. Its etiology, however, remains unknown. In addition, there are not enough studies on eosinophilia in patients on hemodialysis in Korea. Therefore, we performed this retrospective study to find out the prevalence and possible etiologic factors of blood eosinophilia in patients undergoing hemodialysis. Methods Between January 2013 to December 2015, the patients hospitalized for hemodialysis at Soonchunhyang University Hospital and National Health Insurance Service Medical Center (Ilsan Hospital) were included in this study. Eosinophilia was defined when absolute eosinophil count was greater than 500/μL, respectively. We retrospectively reviewed the medical records of patients about parasite infection, other malignancies, and history of kidney transplantation. Results Of the 2,155 patients hospitalized for hemodialysis at two centers, 1,057 patients (49%) were found to have eosinophilia. We investigated 1,199 patients’ information (Soonchunhyang University Hospital) by the medical records. Two hundred two patients (16.8%) had no identifiable and/or possible causes. Only two patients complained of symptoms such as itching. Steroids were administered to control symptoms, and both patients had normal eosinophil levels, and steroids were discontinued. Other patients did not complain of specific symptoms associated with eosinophilia and did not take medication such as steroids. Eosinophilia was improved in 49% of patients without special treatments. Conclusion We found that the eosinophil counts in patients with end stage renal disease on hemodialysis were frequently elevated. However, in most cases, eosinophilia was not clinically relevant.
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