• Title/Summary/Keyword: 다발성 결절 동맥염

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Polyarteritis Nodosa Confined to the Kidneys in a Patient with Proteinuria and Mild Renal Impairment (단백뇨와 경도 신기능장애가 있는 환자에서 진단된 신장에 국한된 결절성 다발성 동맥염 1예: 증례 보고)

  • Young Kyeong Seo;Taehee Kim;Yeong Hoon Kim;Yunmi Kim;Hyuk Huh;Byeong Woo Kim
    • The Korean Journal of Medicine
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    • v.99 no.2
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    • pp.116-121
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    • 2024
  • Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis predominantly involving medium- or small-sized arteries, typically of the kidneys and other internal organs. Given the rarity of PAN and the variable clinical presentation, diagnosis is challenging and, to date, no definitive diagnostic marker has been identified. A patient diagnosed with immunoglobulin A nephropathy was observed to exhibit deterioration in renal function. To determine whether new structural abnormalities had developed, computed tomography scans of the kidneys, ureters, and bladder were obtained. Both kidneys exhibited multiple cortical defects, and a renal angiogram was performed to determine the cause. Angiography revealed partial obliteration of the left distal renal artery branches and multifocal extensive infarctions in both kidneys, and the patient was diagnosed with renal-limited PAN. Following steroid monotherapy, an improvement in renal function was observed. We believe that this case report may be helpful to physicians who assess and treat patients with suspected renal-limited PAN.

A Case Report of Polyarteritis Nodosa Treated with Korean Medical Treatment (결절성 다발 동맥염 환자의 한방치료 치험 1례)

  • Kim, Nan-Ee;Jee, Seon-Young;Hwangbo, Min
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.31 no.2
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    • pp.143-151
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    • 2018
  • Objectives : The purpose of this study is to report the one clinical experience of korean medical treatment on polyarteritis nodosa(PAN). Methods : We treated a 46-year old man patient with acupuncture, pharmacopuncture, Daehwangchoseok-tang, Chijadaehwangsi-tang. We evaluated the improvement of patients by Visual Analogue Scale(VAS) and photography. Results : After the treatments, symptoms of skin lesion including pus, swelling, subcutaneous nodule and bleeding were improved and VAS of pain decreased from 10 to 1. Conclusions : This study shows that the korean medical treatment can improving symptoms of PAN.

Case Report of Polyarteritis Nodosa Treated with Oriental Treatments Including Acupotomy (침도침 시술을 가미한 복합한방치료를 시행한 결절성 다발 동맥염의 치험례)

  • Lee, Eun-Sol;Kam, Chul-Woo;Youn, Hyoun-Min;Jang, Kyung-Jeon;Song, Chun-Ho;Kim, Young-Kyun;Kim, Cheol-Hong
    • Journal of Acupuncture Research
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    • v.29 no.3
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    • pp.129-137
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    • 2012
  • Objectives : Polyarteritis nodosa is a progressive disease of connective tissue that is characterized by nodules along arteries; nodules may block the artery and result in inadequate circulation to the particular area. This report is intended to estimate the efficacy using oriental complex treatment on a patient with Polyarteritis nodosa. Materials and Methods : From 19th March, 2012 to 12th May, 2012, One male inpatient diagnosed with polyarteritis nodosa was treated with general oriental medicine therapy : needle-embedding therapy ; acupuncture ; pharmacopuncture ; acupotomy therapy and herbal medication. VAS(visual analogue scale) was used for evaluation of both leg pain. Other subjective symptoms including night sweat, tinnitus, upper heat were evaluated by percentage comparing the symtoms before and after treatment. Results : The patient showed a certain degree of improvement in both leg pain and other subjective symtoms. Conclusions : Oriental treatments such as needle-Embedding therapy, acupuncture and moxibustion therapy, pharmacopuncture therapy, acupotomy therapy and herbal medication can be effective for controlling pain and other accompanied symtoms due to polyarteritis nodosa.

Clinical Manifestations of the Lung Involvement in Behçet's Syndrome (Behçet 증후군에서 폐침범의 임상양상에 관한 고찰)

  • Park, Kwang Joo;Park, Seung Ho;Kim, Sang Jin;Kim, Hyung Jung;Chang, Joon;Ahn, Chul Min;Kim, Sung Kyu;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.763-773
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    • 1996
  • Background : Behçet's syndrome is a chronic multisystemic disease affecting many organs such as skin, mucosa, eye, joint, central nervous system and blood vessels. Lung involvement occurs in 5% of Behçet's syndrome and is thought to be due to the pulmonary vasculitis leading to thromboembolism, aneurysm and arteriobronchial fistula. Pulmonary vasculitis in Behçet's syndrome is a unique clinical feature, differing from other vasculitis affecting the lung and is one of the major causes of death. Therefore, we examined the incidence, the clinical features, the radioloic findings and the clinical courses of the lung involvement in Behçet's syndrome. Methods: We retrospectively reviewed the medical records and radiologic studies of 10 cases of the lung involvement in Behçet's syndrome diagnosed at Yongdong Severance Hospital and Severance Hospital from 1986 to 1995. We analysed the clinical features, the radiological findings, the treatment modalities and the clinical courses. Results: 1) The incidence of the lung involvement in Behçet's syndrome was 2%(10/487). The male to female ratio was 8 : 2 and the mean age was 34 years. The presenting symptom was hemoptysis in 5 of 10 cases, and massive hemoptysis was noted in 2 cases. Other pulmonary symptoms were cough(6/10), dyspnea(4/10), and chest pain(2/10). Other manifestations were oral ulcers(10/10), genital ulcers(9/10), skin lesions(7/10), and eye lesions(6/10). 2) The laboratory findings were nonspecific. The posteroanterior views of chest radiographies showed multiple infiltrates(6/10), nodular or mass-like opacities(4/10), or normal findings(2/10). The chest CT scans showed multifocal consolidations(6/8), and aneurysms of the pulmonary aneries(4/8). The pulmonary angiographies were performed in 3 cases, and showed pulmonary artery aneurysms in 2 cases. The ventilation-perfusion scans in 2 cases of normal chest x-ray showed multiple mismatched findings. 3) The patients were treated with combination therapy consisting of corticosteroids, cyclophosphamide, and colchicine or anticoagulant agents. Surgical resection was performed in one case with a huge aneurysm. 4) We have followed up nine of ten cases. Three cases are well-being with medical therapy, two cases are severely disabled now and four cases died due to massive hemoptysis, massive pulmonary embolism, or sepsis. Conclusion : Pulmonary vasculitis is a main feature of the lung involvement of Behçet's syndrome, causing hemorrhage, aneurysmal formation, and/or thromboemboism. The lung involvement of Behçet's syndrome is uncommon but is one of the most serious prognostic factors of the disease. Therefore, an aggressive diagnostic work-up for early detection and proper treatment are recommended to improve the clinical course and the survival.

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