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박연희(Youn Hee Park),강은희(Eun Hee Kang),김지현(Jee Heyn Kim),박원도(Wondo Park) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.1
We first report a case that demonstrates superi-mposed acute renal failure associated with rhabdo-myolysis in a patient with tsutsugamushi disease. The clinical presentation was that of insidious onset of fever, abdominal pain, back pain, renal failure and respiratory failure over about 20 days period. The renal function was progressively deteriorated and the serum creatinine concentration increased from 1.4 to 8.4mg/dL, while the patient was in a state of septic shock caused by tsutsugamushi disease. The laboratory data including increased muscle enzymes such as CK, LDH, SGOT, myoglobin, positive test for urine myoglobin, and increased uptake of bone scan were consistent with rhabdomyolysis. On consideration of the cause of rhabdomyolysis in this patient, endotoxin made in the state of septic shock had triggered a muscle necrosis and acute renal failure aggravated by dehydration and metabolic acidosis. She was recovered by the proper use of a IV doxycycline as the therapy of tsutsugamushi disease with a maintenance of renal blood flow by hydration, mannitol, bicarbonate and protection of hypotension. We suggest that rickettsial disease, especially tsutsugamushi disease can result in the acute renal failure by rhabdomyolysis.
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황지영,안정수,한성훈,박원도 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.3
Sj gren's syndrome may be either primary or associated with other connective tissue diseases such as rheumatoid arthritis or systemic lupus erythematosus(SLE). Overt renal involvement in primary systemic sclerosis occurs rarely. The most frequently recognized histopathological renal lesion is interstitial lymphocytic infiltrate with tubular atrophy and fibrosis leading to tubular dysfunction. Glomerulonephritis is distinctly rare in primary. Sj gren's syndrome, with only scattered case reports in the literature. We experienced a 46 year-old female patient who had many manifestations of primary Sj gren's syndrome, but we found membranous glomerulonephritis and chronic interstitial nephritis on renal biopsy.
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엄흥식,김준재,김현수,박영정,최상봉,박원도,김상현 인제대학교 2006 仁濟醫學 Vol.27 No.-
Spinal epidural abscess is an uncommon but readily diagnosable and treatable potential cause of paralysis and death. The incidence of spinal epidural abscess is approximately one to two cases per 10,000 hospital admissions in the United States. The symptoms of spinal epidural abscess are varied but include lower back pain, fever, local tenderness and neurological deficit, especially in such high risk groups as patients with diabetes, intravenous drug abuse, chronic renal failure, alcoholism, liver disease and immunocompromization. Infections of the epidural space originate from contiguous spread or via hematogenous routes from a distant source. Cutaneous sites of infection are the most common remote sources, especially in intravenous drug users. S. aureus accounts for most spinal epidural abscess infections, followed by streptococci and gram-negative anaerobes. We here report a case of spinal epidural abscess in renal abscess patient complaining of fever and back pain. A 71-year old female patient was admitted to epigastric pain and oliguria. She had been diagnosed as acute renal failure and treated with hydration. After third hospital days, she shows a persistent fever and drowsy mentality. Abdominal computed tomography demonstrated renal abscess. She was treated with intravenous antibiotics, third cephalosporin. Blood cultures and urinary culture revealed Escherichia, coli. After fourteenth hospital days, she developed back pain, muscle weakness and decreased sensation of lower extremities. Spine MRI demonstrated spinal epidural abscess with spinal cord compression. Surgical drainage with laminectomy was performed. After treatment of intravenous antibiotics and surgical drainage, she discharged with improved back pain and neurological symptom.
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