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- 저자 : 장형진 ( Hyoung Jin Chang ) (검색결과 3 건)
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증례 : 내분비 ; Alpha Lipoic acid와 연관된 인슐린자가면역증후군 1예
장형진 ( Hyoung Jin Chang ),최현숙 ( Hyun Sook Choi ),박미연 ( Mi Youn Park ),임성민 ( Sung Min Leem ),장이선 ( Yi Sun Jang ),박강서 ( Kang Seo Park ),이종민 ( Jong Min Lee ) 대한내과학회 2009 대한내과학회지 Vol.76 No.5
당뇨병으로 경구 혈당 강하제 복용 중에 발생한 저혈당으로 내원한 71세 여자에서 혈청 인슐린 수치와 인슐린자가 항체가 높게 측정되어 인슐린자가면역증후군으로 진단하였다. 약 4주 전부터 sulfhydryl기가 있는 치옥타시드를 복용하였고, HLA 분석결과 인슐린자가면역증후군에서 추출되는 Cw4, DRB1*0406이 나와 확진할 수 있었으며 프레드니솔론 투여로 저혈당 증세는 호전되었다. 이미 당뇨병으로 치료 중인 환자에서는 빈번한 저혈당이 온다고 해도 인슐린자가면역증후군을 고려하기 쉽지 않지만 전 세계적으로 동아시아 지역에서 유병률이 높은 것을 감안하면 이 질환을 염두 해두어야 할 것이다. Insulin autoimmune syndrome is characterized by spontaneous hypoglycemia, high concentrations of serum immunoreactive insulin, and the presence of autoantibodies to insulin without previous insulin injection. A 71-year-old woman with diabetes, who had been treated with oral hypoglycemic agents, suffered from frequent hypoglycemia. High insulin levels and the presence of insulin autoantibodies were shown, so insulin autoimmune syndrome was diagnosed. Drugs containing sulfhydryl groups play an important role in the pathogenesis of insulin autoimmune syndrome. Alpha-lipoic acid, which contains a sulfhydryl group, was administered before the onset of hypoglycemia. The patient`s human leukocyte antigen (HLA) type was HLA-Cw4 and DRB1*0406. There is a strong correlation between HLA-DRB1*0406 and insulin autoimmune syndrome. The patient was treated with prednisolone and has not had a hypoglycemic attack since. We report a case of insulin autoimmune syndrome, possibly associated with alpha-lipoic acid. (Korean J Med 76:600-604, 2009)
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최우형 ( Woo Hyung Choi ),장형진 ( Hyoung Jin Chang ),승지환 ( Jee Hwan Seung ),고봉석 ( Bong Suk Ko ),강상범 ( Sang Bum Kang ) 대한소화기학회 2013 대한소화기학회지 Vol.62 No.3
A jejunal ectopic pancreas, where pancreatic tissue is found outside of the usual anatomical location, is a rare submucosal tumor that may cause obscure gastrointestinal (GI) bleeding. After initial negative endoscopic evaluation of the obscure GI bleeding, including colonoscopy and/or upper endoscopy, it is reasonable to proceed with further evaluation of the small bowel. Diagnostic options for the evaluation of the small bowel may include capsule endoscopy, push enteroscopy, or barium contrast small bowel studies. Here, we report a case of obscure GI bleeding caused by a jejunal ectopic pancreas, diagnosed through capsule endoscopy and barium contrast small bowel studies, which was treated successfully with single incision access laparoscopy. (Korean J Gastroenterol 2013;62:165-168)
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박철홍 ( Cheol Hong Park ),임창훈 ( Chang Hoon Lim ),장형진 ( Hyoung Jin Chang ),손상원 ( Sang Won Son ),정성진 ( Sung Jin Jung ),박철휘 ( Cheol Whee Park ),장윤식 ( Yoon Sik Chang ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.2
A 46-year-old woman with chronic renal failure due to polyarteritis nodosa was referred to the hospital for evaluation of abdominal pain. She had been treated with cathartics (magnesium oxidate 2.0 g/day) for constipation for several days. One day before the admission, the patient had been taken magnesium enema twice at another hospital. On admission, she was comatose, suffering from lethargy and respiratory failure. Her serum magnesium and amylase concentrations were markedly elevated (8.2 mg/dL and 1,698 IU/L respectively), and plain abdominal image and abdominal computed tomography revealed acute pancreatitis and non-obstuctive ileus. Thereafter, aggressive cardiopulomonary support with mechanical ventilation and continuous renal replacement therapy using continuous veno-venous hemofiltration (CVVH) applied due to cardio-respiratory failure and hypermagnesemia. After 3 days of CVVH treatment, the concentration of serum magnesium was normalized to 3.2 mg/dL, and respiratory failure and abdominal ileus were markedly improved. Four days after aggressive treatment, her hemodynamic and gastroenteric symptoms stabilized. Therefore, we report the case of hypermagnesemia with acute pancreatitis, severe hypotension and respiratory failure after cathartic ingestion and enema containing magnesium oxidate treated with CVVH.
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