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반복적인 호흡기 감염과 천식 악화가 동반된 IgG3 아형 결핍증 성인 환자에서 intravenous immunoglobulin 사용 1예
이홍열 ( Hong Yeul Lee ),윤상원 ( Sang Won Yoon ),김영 ( Young Kim ),조환준 ( Hwan Jun Cho ),이주영 ( Joo Young Lee ),구강모 ( Kang Mo Gu ),박태연 ( Tae Yun Park ),최재철 ( Jae Chol Choi ),신종욱 ( Jong Wook Shin ),김재열 ( Jae Y 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.3
The IgG subclass deficiency is defined as a significant decrease in the serum concentrations of one or more subclasses of IgG in a patient whose total IgG concentration is normal. IgG subclass deficiency can predispose to recurrent sinopulmonary infections. A 29-year-old female patient with a 4-year history of bronchial asthma presented with cough, sputum, dyspnea, and recurrent respiratory infections. She had frequently been treated with antibiotics and systemic steroids for recurrent respiratory infections and acute asthma exacerbations. Chest X-ray and computed tomography showed pectus excavatum and bronchial wall thickening without lung parenchymal abnormalities. On immunological evaluation, she was found to have a low serum IgG3, with normal total IgG concentration. Under diagnosis of selective IgG3 deficiency, she was started on monthly infusions of intravenous immunoglobulin (IVIG) therapy. The frequency and severity of respiratory infections and acute asthma exacerbations were markedly decreased during 3 years of IVIG therapy. Our case report suggests that a patient who has underlying selective IgG3 deficiency and asthma may benefit from IVIG therapy as this can significantly reduce the incidence and severity of recurrent respiratory infections and acute asthma exacerbations. (Allergy Asthma Respir Dis 2016;4:225-229)
탄광부 진폐증 환자에 동반된 기관지 탄분섬유화증의 임상적 의의
김미혜 ( Mi Hye Kim ),이홍열 ( Hong Yeul Lee ),남기호 ( Ki Ho Nam ),임재민 ( Jae Min Lim ),정복현 ( Bock Hyun Jung ),류대식 ( Dae Sick Ryu ) 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.2
Background: In previous study, most patients with bronchial anthracofibrosis (BAF) were non-miners, and non-occupational old aged females. However, the clinical significance of BAF in patients with coal workers` pneumoconiosis (CWP) is unknown. Methods: Among patients with CWP who transferred to our hospital for an evaluation of associated pulmonary diseases, 32 patients who had undergone a bronchofibroscopy (BFS) and chest computed tomography (CT) examination were evaluated for the association of the BAF using a retrospective chart review. Results: Nine of the 32 CWP patients (28%) were complicated with BAF. Four of the 16 simple CWP patients (25%) were complicated with BAF. According to the International Labor Organization (ILO) classification by profusion, 2 out of 3 patients in category 1, 1 out of 8 patients in category 2 and 1 out of 3 patients in category 3 were complicated with BAF. Five out of 16 complicated CWP patients were complicated with BAF. Three out of 7 patients in type A and 2 out of 5 patients in type C were complicated with BAF. CWP patients with BAF had significantly greater multiple bronchial thickening and multiple mediastinal or hilar lymph node enlargement than the CWP patients without BAF. There was no difference in the other clinical features between the CWP patients with BAF and those without BAF. Conclusion: Many CWP patients were complicated with BAF. The occurrence of BAF was not associated with the severity of CWP progression. Therefore, a careful evaluation of the airway with a bronchoscopy examination and chest CT is warranted for BAF complicated CWP patients who present with respiratory symptoms and signs, even ILO class category 1 simple CWP patients.
정상인에서 발생한 Mycobacterium Intracellulare에 의한 관절염 1예
강경훈 ( Gyung Hoon Kang ),김성훈 ( Sung Hoon Kim ),이홍열 ( Hong Yeul Lee ),서현웅 ( Hyun Woong Seo ),송은희 ( Eun Hee Song ),이기원 ( Ki Won Lee ),김성수 ( Sung Soo Kim ) 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.2
Nontuberculous mycobacteria (NTM) are widely distributed in nature and are usually of low pathogenic potential. NTM rarely has been recognized as a cause of musculoskeletal infections that involve joints, bone and soft tissue in immunocompetent patients. The risk factors of its infection are local traumas caused by surgery, injury, or injection. A fifty five-year-old immunocompetent patient visted to hospital due to right wrist mass and pain. Excisional biopsy was done. Histologically granulomatous inflammation was identified and Mycobacterium intracellulare was cultured. Although very rare, NTM should be suspected at least once as a causative pathogen of chronic arthritis when the cause is uncertain.