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궤양성 대장염 환자에서 발생한 우측 대장의 위막성 대장염 1예
주희린 ( Hee Rin Joo ),김태오 ( Tae Oh Kim ),김태균 ( Tae Gyoon Kim ),서은희 ( Eun Hee Seo ),박종하 ( Jongha Park ),박승하 ( Seung Ha Park ),양성연 ( Sung Yeon Yang ),문영수 ( Young Soo Moon ) 대한장연구학회 2011 Intestinal Research Vol.9 No.2
Clostridium difficile (C. difficile) is a cytotoxin-producing anaerobic gram-positive rod that is responsible for pseudomembranous colitis (PMC). The incidence of C. difficile is increasing in ulcerative colitis (UC) and inflammatory bowel disease patients and is associated with a more severe course, a longer hospital stay, higher financial costs, a greater likelihood of colectomy, and high mortality. PMC may occur anywhere along the intestinal tract, but it is often found in the distal colon. PMC involving the proximal colon with rectosigmoid sparing is rarely reported in patients with UC. We describe the case of a 35-year-old woman in remission from UC who presented with frequent diarrhea and abdominal pain. She was treated with ciprofloxacin for infectious enterocolitis at a local hospital; however, her symptoms did not improve. A colonoscopy revealed yellow-white plaques with edematous,erythematous from the proximal ascending colon to the cecum, and feces positive for C. difficile toxin. She was treated with metronidazole (500 mg, three times a day) for two weeks, and improved rapidly. Physicians should carefully examine the entire colon via colonoscopy, and perform stool exams for C. difficile in patients with UC who have been treated with antibiotics and in those who develop prolonged diarrhea despite medical treatment. (Intest Res 2011;9:144-147)
주희린,안원석,이성원,정원태,나서희,김성은,김기현 대한내과학회 2003 대한내과학회지 Vol.65 No.2
저자들은 전신성홍반성 루푸스의 ClassⅠ병변에 미세변화 신증후군이 동반되어 고용량의 스테로이드 요법으로 관해를 이루고 이후 재발하여 재차 신생검 결과 막성신병증으로 확인된 환자에서 cyclophosphamide로 다시 관해를 이룬 매우 드문 증례를 경험하였기에 보고하는 바이다. Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by the overprocuction of autoantibodies and the deposition of immune complexes in various organs. Unusual case of systemic lupus erythematosus (SLE) associated with minimal change nephrotic syndrome (MCNS) is described. A 30-year-old woman who has been diagnosed as SLE and treated with prednisolone presented symptoms of nephrotic syndrome. Renal biopsy revealed minor glomerular abnormalities without deposition of immune complexes. The initial heavy proteinuria promptly decreased after the prednisolone dosage was increased and disappeared 10 weeks later. She developed proteinuria again 3 years after the initial episode. Repeated renal biopsy revealed membranous nephropathy. T-cell dysfunction, which is present both in SLE and MCNS, might have triggered MCNS during the course of SLE.