• Title/Summary/Keyword: 루푸스 신염

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Glomerular Detection for Diagnosis of Lupus Nephritis using Deep Learning (딥러닝을 활용한 루푸스 신염 진단을 위한 생검 조직 내 사구체 검출)

  • Jung, Jehyun;Ha, Sukmin;Lim, Jongwoo;Kim, Hyunsung;Park, Hosub;Myung, Jaekyung
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2022.07a
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    • pp.85-87
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    • 2022
  • 루푸스 신염을 정확히 진단하기 위해서는 신장의 침 생검을 통한 조직검사를 통해 사구체들을 찾아내고, 각각의 염증 정도를 분류해야 한다. 하지만 이에는 의료진의 많은 시간과 노력이 소요된다. 따라서 본 연구에서는 이러한 한계를 극복하기 위해 합성곱 신경망 (Convolutional neural network, CNN)에 기반한 검출 및 분할에 딥 러닝 접근법을 적용하는 YOLOv5 알고리즘을 통해 검체 이미지 내에서 사구체를 자동으로 검출해 내도록 하였다. 그리고 루푸스 신염 환자의 슬라이드 이미지에 대한 태깅 작업을 거쳐 학습을 위한 데이터와 테스트를 위한 데이터를 생성하여 학습 및 테스트에 활용하였다. 그 결과 고화질의 검체 이미지 내에서 대부분의 사구체를 0.9 이상의 높은 precision과 recall로 검출해 낼 수 있었다. 이를 통해 신장 내부의 사구체 검출을 자동화하고 추후 연구를 통해 사구체 염증 정도를 단계화 할 수 있는 발판을 마련하였다.

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Diagnosis of Systemic Lupus Erythematosus During Medical Follow-up After Urinary Screening (학교 집단 요 검사 이상으로 추적검사 중 전신 홍반 루푸스로 진단된 1예)

  • Yoon, So-Jin;Song, Ji-Eun;Shin, Jae-Il;Jeong, Il-Cheon;Lee, Jae-Seung;Shim, Hyo-Sup;Jeong, Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.227-232
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    • 2008
  • A 16-year-old girl presented with proteinuria and microscopic hematuria detected through mass urinary screening and was diagnosed as having suspected postinfectious glomerulonephritis by renal biopsy. However, heavy proteinuria did not respond to angiotensin converting enzyme inhibitor therapy. After 6 months, cervical lymphadenitis developed and a neck node biopsy showed subacute necrotizing lymphadenitis. After an additional 2 months, she developed facial erythema and thrombocytopenia. A repeat renal biopsy demonstrated lupus nephritis class IV. She was treated with pulse methylprednisolone(500 mg/day intravenously for 3 consecutive days) followed by oral deflazacort and monthly intravenous cyclophosphamide pulse(1 g/$m^2$) for 6 months. We report a case diagnosed as systemic lupus erythematosus(SLE) during medical follow-up after urinary screening.

A Case of "Full-house" Nephropathy in a Non-lupus Patient (병리조직검사에서 "Full-house" 패턴의 면역 복합체 침착이 발견된 비루푸스 신염)

  • Yoo, Ha Yeong;Son, Mikyung;Cho, Myung Hyun;Kwak, Byung Ok;Park, Hye Won;Lim, So Dug;Chung, Sochung;Kim, Kyo Sun
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.128-131
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    • 2014
  • Histopathologic evidence of "full-house" immune complex deposits is a pathognomonic feature of lupus nephritis. This report presents the case of a 12-year-old boy with persistent microscopic hematuria and proteinuria. He was diagnosed with "full-house" nephropathy based on a renal biopsy. However, there was no other clinical or biological evidence of systemic lupus erythematosus (SLE). Although the potential for isolated "full-house" nephropathy preceding SLE is unclear, such patients should be followed for clinical signs and autoantibodies of SLE. In most cases, microscopic hematuria has a good prognosis, and follow-up usually requires only regular urinalysis. However, we should be aware of isolated "full-house" nephropathy that remains asymptomatic for a long time, as few patients with no clinical signs and negative serology ultimately develop SLE.

A Case of Lupus Nephritis with Positive Antiphospholipid Antibodies, Initially Detected Through Analysis of Urinary Mass Screening (학교신체검사에서 발견된 항인지질 항체 양성 낭창성 신염 1례)

  • Lee Taek-Jin;Choi Min Sook;Lee Young-Mock;Kim Ji-Hong;Kim Pyung-Kil;Jeong Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.219-224
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    • 2001
  • Antiphospholipid syndrome is a thrombotic disorder characterized by the association of arterial and venous thrombosis with the antibodies directed toward phospholipids. The presence of these antibodies in systemic lupus erythematosus(SLE) has been shown to be related to several clinical and analytical alterations. We experienced one case of lupus nephritis with positive antiphospholipid antibodies in a 10-year-old girl whose chief complaint was persistent microscopic hematuria. We report this case with a brief review of related literatures. (J. Korean Soc Pediatr Nephrol 2001 ;5 : 219-24)

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An Analysis of 94 Percutaneous Renal Biopsies (경피적 신생검 94례에 대한 분석)

  • Kang, Ho-Jung;Lim, Sang-Woo;Do, Joo-Yeung;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.84-95
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    • 1995
  • A clinical and histopathological study was performed on ninety-four patients with nephrotic syndrome (91 idiopathic and 3 secondary) who were admitted to Department of Internal Medicine, Yeungnam University Hospital during the period of nine years, from January 1985 to May 1994. The results were as following. 1. the ratio of male to female was 1.76:1. In young age group, minimal change was the most predominant type. In old age group, membranous glomerulonephritis and focal glomerulosclerosis were predominant types. 2. The primary nephrotic syndromes were 96.8% and secondary nephrotic syndromes were 3.2%. Histopathologic findings of 94 renal biopsy tissue were classified into minimal change (43.6%), mesangial proliferative glomerulonephritis (29.8%), membranous glomerulonephritis (12.8%), TypeI membranous proliferative glomerulonephritis (4.3%), focal glomerulosclerosis (3.2%) and others (6.4%). 3. The response of eighty-six patients treated with steroid showed complete remission in 51.2%, partial remission in 20.9%, steroid dependent in 2.3%, and no effect in 25.6% of cases respectively. The response to steroid therapy was most effective in the patients with minimal change lesion. 4. In the patient with membranous proliferative glomerulonephlitis, long-term angiotensin converting enzyme inhibitor treatment showed less deterioration of renal function.

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Analysis of Childhood Rapidly Progressive Glomerulonephritis (소아 급속 진행성 사구체신염의 임상적 고찰)

  • Uhm Ji Hyun;Kim Mi Jin;Lee Young-Mock;Kim Ji Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon Won;Jeung Hyeun Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.78-86
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    • 2001
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is characterized by the rapid increase in serum creatitnin and crescents formation involving more than $50\%$ of glomeruli. 10 patients who had been treated for RPGN were studied retrospectively for thier underlying diseases and clinical features Method: Cilinical review was performed on 10 children who were diagnosed with RPGN by clinical features and renal biopsy and followed up at department of pediatrics during tile last 10 years, from May 1990 to May 2000. Result: There were 6 males and 4 females between the ages of 2.1 and 14.3 years (mean $10.9{\pm}3.8$). 3 had Henoch-$Sch{\ddot{o}}nlein$ purpura nephritis; 2, idiopathic rapidly progressive glomerulonephritis; 2, lupus nephritis; 1, hemolytic uremic syndrome; 1, membranous glomerulonephritis and 1, microscopic polyangiitis. The most common chief complaints were gross hematuria and oliguria. Initial clinical features included proteinuria, edema, hypertension, nausea and arthralgia. Mean serum BUN was $74.2{\pm}39.1\;mg/dL$ mean serum creatinin, $3.2{\pm}1.8\;mg/dL$ and mean creatinin clearance, $26.5{\pm}13.2\;mL/min/1.73m^2$. Antineutrophil cytoplasmic antibody was positive only in microscopic polyangiitis. ANA and Anti-DNA antibody were positive in two lupus nephritis patients. Serum complements were decreased in 4 patients. All patients except Hemolytic uremic syndrome received steroid pulse therapy and immunosupressive agents. 3 patients were performed acute peritoneal dialysis and 2 patients were given plasmapheresis. At the last follow up, 1 patient was dead, 4 patients had elevated serum creatinin, 2 of these 4 patients were on chronic ambulatory peritoneal dialysis and 6 patients had normal renal function. Conclusion: Rapidly progressive glomerulonephritis is a medical emergency that requires very rapid diagnosis, classification, and therapy. Appropriate therapy selected on the basis of underlying disease mechanism can substantially improve renal survival. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 78-86)

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