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지주막하 출혈로 내원한 호산구육아종증다발혈관염 환자 1예
오세환 ( Se Hwan Oh ),박원 ( Won Park ),권성렬 ( Seong Ryul Kwon ),임미진 ( Mie Jin Lim ),주고운 ( Ko Woon Joo ),이오현 ( Oh Hyun Lee ),이하영 ( Ha Young Lee ),오세양 ( Se Yang Oh ),정경희 ( Kyong Hee Jung ) 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.3
Eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss syndrome, is an anti-neutrophil cytoplasmic antibody associated vasculitis, accompanied by asthma, hypereosinophilia, nonfixed pulmonary infiltrates, and sinusitis. Peripheral neuropathy is common in patients with EGPA; however, a few cases of EGPA with central nervous system (CNS) involvement have been reported. A 45-year-old female referred for right side weakness and posterior neck pain was diagnosed as EGPA with subarachnoid hemorrhage and mononeuritis multiplex. She was effectively treated with a high dose glucocorticoid, cyclophosphamide, and intravenous immunoglobulin. EGPA with CNS involvement is uncommon and causes significant morbidity and mortality. Therefore more rapid and accurate diagnostic evaluation may be required. EGPA should be considered in patients with neurological symptoms and hypereosinophilia. (J Rheum Dis 2015;22:190-194)
윤광석 ( Gwang Seok Yoon ),박원 ( Won Park ),백지현 ( Ji Hyeon Baek ),한지영 ( Jee Young Han ),정경희 ( Kyong Hee Jung ),임미진 ( Mei Jin Lim ),주고운 ( Ko Woon Joo ),권성렬 ( Seong Ryul Kwon ) 대한류마티스학회 2013 대한류마티스학회지 Vol.20 No.6
Adult-onset Still`s disease (AOSD) is a rare systemic inflammatory disease characterized by spiking fever, arthralgia, salmon pink rash, neutrophilic leukocytosis, and multi-organ involvement. Although renal involvement may appear in some cases of adult Still`s disease, onset over 70 years of age with renal involvement has not been described. We report a 73-years-old woman whose illness manifested with fever of unknown origin, massive proteinuria, and multiple lymph nodes enlargement. With proteinuria of 2,650 mg/day, a renal biopsy was performed, and histopathological evaluation yielded the diagnosis of chronic glomerulonephritis (CGN). After excluding infectious disease, malignancy, and other rheumatic disease, AOSD was diagnosed with symptoms including fever over 39.0oC for more than a week, leukocytosis, generalized lymphadenopathy, and negative autoantibodies. Proteinuria and fever were improved markedly by high dose glucocorticoids and methotrexate therapy.
증례 : 호흡기 ; 급성호흡곤란증후군으로 나타난 NK-T 세포 림프종
김정수 ( Jung Soo Kim ),민경선 ( Kyung Sun Min ),최석진 ( Seok Jin Choi ),남해성 ( Hae Sung Nam ),조재화 ( Jae Hwa Cho ),정은선 ( Eun Seon Jeong ),주고운 ( Ko Woon Joo ) 대한내과학회 2010 대한내과학회지 Vol.79 No.6
양측성 폐침윤을 보인 49세 여자에서 항생제 복합투여에도 상태가 더욱 악화되고 급성호흡곤란증후군으로 진행하였다. 폐병변의 원인을 밝히기 위하여 기관지 폐포 세척 및 폐생검을 시행하였고, NK-T 세포 림프종을 진단하여 보고하는 바이다. Primary pulmonary lymphoma is a rare disease, and non-B cell lymphomas (T-cell and natural killer cell lymphomas) involving the lung parenchyma are uncommonly reported. The most common radiological feature of pulmonary parenchymal lymphoma is a single mass or nodule. A 49-year-old woman with dyspnea was referred with suspicion of severe pneumonia. A chest radiograph showed diffuse nodular infiltration in both lungs. Acute respiratory failure was severe and rapidly progressive, so she was managed with a mechanical ventilator under the impression of acute respiratory distress syndrome (ARDS). A bronchoalveolar lavage and lung biopsy by video-assisted thoracic surgery revealed NK-T cell lymphoma. We report a case of extranodal NK-T cell lymphoma presenting as ARDS. (Korean J Med 79:697-700, 2010)