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만성 신부전 환자에서 은단 복용과 동반되어 발생한 전신적 은 중독증
길효욱 ( Gil Hyo Ug ),이준영 ( Lee Jun Yeong ),권순효 ( Kwon Sun Hyo ),조원영 ( Jo Won Yeong ),박종근 ( Park Jong Geun ),양종오 ( Yang Jong O ),이은영 ( Lee Eun Yeong ),홍세용 ( Hong Se Yong ) 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.2
Generalized hyperpigmentation has a wide range of causes, including endocrine diseases, including endocrine diseases, uremia, drugs, and heavy metals. Cutaneous pigmentation observed in 70% of uremic patients on hemodialysis. However, it is clinically difficult to define the exact cause of hyperpigmentation in chronic renal failure patients. We experienced a case of cutaneous hyperpigmentation caused by generalized argyria in chronic hemodialysis patient. A 38-year-old male patient presented with slowly progressive blue-black discoloration of skin. He had been on maintenance hemodialysis for 5 yars and took sliver pills 36 g daily during 2.5 years to relieve thirst. The other source of silver exposure could not be determined. Pathologic examination of skin biopsy specimen showed focal deposits of fine, uniform, brownish granules along the basement membrane zone of hair in the dermis, which is characteristic findings of argyria. The silver deposits were also confirmed by increase in serum silver level and silver amount in liver and skin tissue. Argyria should be suspected in chronic hemodialysis patients presenting with a diffuse bluish-gray discoloration of the skin and nails and evaluated carefully by skin biopsy with quantitation of tissue silver level. (Korean J Nephrol 2004;23(2):345-348)
Erythropoietin 항체에 의해 유발된 진성 적혈구 무형성증 (Pure Red-cell Aplasia)
양종오 ( Yang Jong O ),길효욱 ( Gil Hyo Ug ),권순효 ( Kwon Sun Hyo ),최영진 ( Choe Yeong Jin ),이은영 ( Lee Eun Yeong ),홍세용 ( Hong Se Yong ) 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.3
Recombinant human erythropoietin (rHuEPO) is extensively used in anemic patients on dialysis. We experienced a case of pure red-cell aplasia (PRCA) caused by anti-rHuEPO Antibody. A 48-year-old male with CRF was placed on chronic hemodialysis. He developed severe anemia (Hb 6.6 g/dL) without any apparent blood loss. A transfusion was given and the rHuEPO dose was increased to 12,000 U/week SC. A bone marrow study was carried out. Anti-rHuEPO antibodies were positive. rHuEPO therapy was stopped. No improvement in the anemia was apparent. Although very rare, anti-rHuEPO an tibodies should be evaluated in patients with severe anemia without obvious etiology. (Korean J Nephrol 2004;23(3):528-531)