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빈혈을 동반한 만성신부전에서 Recombinant Human Erythropoietin 의 효과
이경생(Kyoung Saeng Lee),이인생(In Saeng Lee),한수용(Su Yong Han),추장식(Jang Sik Choo),서상렬(Sang Yeol Suh),송창섭(Chang Sup Song) 대한내과학회 1993 대한내과학회지 Vol.45 No.1
N/A Background: Anemia is a major complication of chronic renal failure. Recombinant human erythropoietin (rhuEPO) has proven to be a highly effective treatment for the anemia of end-stage renal disease. Methods: We administered rhuEPO to 15 anemic patients of end-stage renal disease who were undergoing hemodialysis. Recombinant human erythropoietin was given intravenously twice a week after dialysis. Transfusion requirements, hemoglobin, hematocrit, reticulocyte, ferrokinetics, BUN, creatinine, electrolytes and adverse reactions were monitored. Results: 1) In 15 patients treated for 8 weeks, hemoglobin level increased from initial mean (±SD) 6.4±0.64 g/dl to 8.6±0.69g/df (p<0.01). Hematocrit level increased from initial mean 18.9±1.79% to 25.2±3.36% (p<0.01). Reticulocyte level increased from initial mean 1.2±0.93% to 2.1±1.02% (p<0.01). 2) Serum iron level decreased from initial mean 128.3±98.54 ㎍/dl to 95.4±75.41 ㎍/dl (p<0.01) and ferritin level decreased from initial 1454.3±732.52±52 ng/dl to 1213.5±534.43 ng/dl (p<0.05). 3) There were no significant differences in the serum levels of BUN, creatinine, Na K and phosphorus before and after the treatment. 4) Adverse reactions of rhuEPO were observed in 2 patients. One was occlusion of arteriovenous fistula and the other was severe itching sensation. 5) The patients were transfused 1.6 pints of packed red cell per month before the treatment, but they no longer needed transfusion after the treatment. Conclusion: These results suggest that recombinant human erythropoietin is safe and may eliminate the need for transfusion in anemic patients of end-stage renal disease.
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갑상선 기능 항진증에 동반된 자가 면역성 용혈성 빈혈 1예
민현조,박석영,홍임작,이경생,이인생,서상렬,송창섭,마경란 대한내과학회 1992 대한내과학회지 Vol.42 No.1
저자들은 자가면역질환의 일부인 갑상선기능항진증이 있는 19세의 여자환자에서 갑상선중독발증과 자가면역성용혈성 빈혈이 동시에 발병하였다가 갑상선기능의 호전과 더불어 용혈성빈혈도 회복된 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hemolytic anemia(AIHA) is a disease characterized by shortened red cell surivival and evidence of immune response directed toward autologous red cells, most frequently demonstrated by a positive direct antiglobulin reaction. The etiology of AIHA, as with other autoimmune disease, is unknown, In many patients with idiopathic AIHA, erythrocyte autoantibodies are the only recognizable evidence of immunologic aberration. AIHA may be classified by idiopathic and secondary on the basis of presence of underlying disorder, and on the other hand, classified by warm induced and cold induced AIHA on the basis of serologic characteristics of involved autoimmune process. Whereas the majority of AIHA are mediated by warm-induced autoantibodies, a smaller portion by cold-induced autoantibodies. Warm-induced AIHA is developed usually by IgG, and cold-induced by IgM. AIHA associated with hyperthyroidism are very rare, but a few cases have reported in the world. We experienced one case of AIHA associated simultaneously with hyperthyroidism in a 19 year-old female patient. The direct and indirect Coombs' test and thyroglobulin antibody were positive. It was demonstrated that hemolysis was induced by IgG antibody. The patient was resolved by antithyroidal drug and prednisone. But hemolytic anemia and hyperthyroidism recurred a few month after discontinuing the drugs. After thyroidectomy, hemolytic anemia was not recurred.
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신미경,한수용,송창섭,이양규,이경생,이인생,서상렬 대한내과학회 1992 대한내과학회지 Vol.43 No.6
Primary biliary cirrhosis is a chronically progressing cholestatic liver disease, which is characterized by the prescence of Anti-mitochondrial antibody in the serum, and affects mainly middle aged women. As, we discovered the cholestatic disease in a young female patient. We report here the case and review about primary biliary cirrhosis.
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