미세 변화형 신증후군과 동반된 급성 무결석 담낭염 1례

A Case of Acute Acalculous Cholecystitis Superimposed on the Nephrotic Syndrome

저자들은 4세에 신증후군으로 진단받고 스테로이드를 투여하며 재발을 수 회 반복하던 환자가 갑작스런 복통과 구토를 주소로 입원하여 시행한 검사 상 급성 무결석 담낭염으로 진단받고 금식, 비 위관 배액, 충분한 수액 공급, 그리고 항생제치료로 완치된 경우를 경험하였기에 이를 보고하는 바이다.

The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 $mg/m^2/hr$), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.