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강용석 ( Yong Seok Kang ),하성삼 ( Seong Sam Ha ),성재호 ( Jae Ho Seong ),한용재 ( Yong Jae Han ),임유리 ( Yoo Li Lim ),이태식 ( Tae Sic Lee ),김효열 ( Hyo Yeol Kim ),김영근 ( Young Keun Kim ),김종구 ( Jong Koo Kim ),박연철 ( Yon 전북대학교 의과학연구소 2014 全北醫大論文集 Vol.38 No.2
Indeterminate western blot in HIV infection can be due to seroconversion during acute HIV infection, advanced HIV infection or infection with HIV-2. In this report, we describe a patient whose advanced HIV infection was identified by a positive combined antigen/ antibody test and detectable viremia, with an inch of being misdiagnosed as acute HIV syndrome. A 23-year-old male was admitted with fever, myalgia, diarrhea and weight loss. He denied previous history of HIV infection, sexual contact and transfusion. Indeterminate western blot result made us misdiagnosis as a seroconversion in acute HIV syndrome. He denied his disease and insisted to delay antiretroviral therapy until positive western blot results. We had question about very low CD4 cell count (22/uL), and asked HIV/AIDS national registry for his previous registration. He was diagnosed HIV infection via blood donor screening 22 months before admission, but was not informed of the result. Finally the patient was confirmed advanced HIV infection and started antiretroviral therapy.
성재호 ( Jae Ho Seong ),김현식 ( Hyun Sik Kim ),강용석 ( Yong Seok Kang ),하성삼 ( Seung Sam Ha ),남승완 ( Seoung Wan Nam ),박정은 ( Jeong Eun Park ),한용재 ( Yong Jae Han ),공지현 ( Jee Hyun Kong ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.2
Unlike most animals, humans are unable to synthesize vitamin C and dependent on vitamin C from vegetables or fruits. Vitamin C deficiency may lead to hyperkeratosis of hair follicles, gingivitis, anemia, arthritis, general fatigue, and depression, and may cause bleeding within the soft tissues. The diagnosis of scurvy can often overlooked because it is rarely encountered in present-day society. A 54-year-old male admitted hospital because of right leg pain due to huge hematoma. He had no trauma and medication history. He`s been unemployed, and rarely eating vegetable and fruit for decades. We could see huge painful hematoma of right thigh. Erythematous and swollen gingiva was also noted. His coagulation profiles were within normal limits. However his blood cell count, the concentration of vitamin C and folate were low. As we diagnosed as scurvy, we supplied vitamin C and folic acid to him. This treatment leads to rapid reversal of scorbutic changes. Scurvy should be considered as a differential diagnosis in the setting of hemorrhagic disease, and detailed history taking is necessary. Along with literature review, we report a case of scurvy accompanied by pancytopenia whose clinical and hematologic symptoms improved with administration of vitamin and folic acid.