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구영석 ( Young Suck Goo ),신현준 ( Hyun Joon Shin ),정재호 ( Jae Ho Chung ),경희두 ( Hee Doo Kyung ),손주혁 ( Joo Hyuk Sohn ),최성희 ( Seung Hee Choi ),박용범 ( Yong Beom Park ),신동환 ( Dong Whan Shin ),이수곤 ( Soo Kon Lee ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.2
Wegener`s granulomatosis (WG) is a multisystemic inflammatory disease characterized by necrotizing granulomatous inflammation and vasculitis of unknown etiology which classically affects the upper airway, lung, and kidney. Subglottic stenosis (SGS) is rare and occurs independently of other features of active WG. SGS can be a life-threatening manifestation of disease, and prompt diagnosis is essential. Since the presenting symptoms of SGS can be nonspecific, SGS should be considered in the differential diagnosis of any patient with WG who has increasing dyspnea, voice change, or cough. Although both surgical and medical treatments have been utilized, the optimal therapeutic approach to SGS in patients with WG has not been determined. So far, a case of WG with SGS has not been reported in Korea. Recently, we experienced a case of 59-year-old woman with SGS in WG. She responded to prednisolone and methotrexate therapy and did not require surgical intervention. So we report this case with a review of literatures.
박영수,최창환,안상훈,송건훈,전재윤,한광협,문영명,박영년,정준원,이관식,이현웅,손주혁,정재연 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.4
Background / Aims : The relationship between HBV infection and nephropathy has been reported with some differences according to the investigators and regions studied. Liver biopsis were not performed in most of the reports. In this study both liver and kidney biopsis were performed. The histologic correlation was analyzed between chronic B viral hepatitis and nephropathy. Methods : From January 1985 ro june and hebaturia. Also, a new histopathologic calssification of chronic hepatitis was applied in the assessment of liver disease. Results : Light microscopy of kidneys showed IgA nephropathy in 7 cases(27%) ; minimal change nephrotic syndrome(MCNS) in 1 case (3.8%); and membranous glomerulonephritis(MGN) in 9 cases(34.6%), membranoproliferative glomerulonephritis (MPGN) in 9 cases (34.6%). Among the cases with a higher hepatitis activity index and fibrosis score, the frequency of MGN and MPGN was higher. The hepatitis activity index of cases with MGN was significantly higher than IgA nephropathy and MPGN (p=0.011, p=0.039). The fibrosis score of cases with MGN and MPGN was significantly higher than IgA nephropathy (p=0.011, p=0.003). The positivity of HBeAg was highest in cases with MGN.Serum C3 level was low in all cases but the serum C4 level was within normal range. Immunofluorescence studies showed granular deposition of Ig G and C3 in the capillary loops in MGN. Conclusion : The frequency of MGN and MPGN was higher when the liver disease was more severe. It was suggested that HBeAg, IgG AND C3 might ci\ontribute to the pathogenesis of MGN in HBsAg positive patients.