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Epidemiology and Clinical Manifestations of $Henoch-Sch\"{o}nlein$ Purpura in Children (소아 $Henoch-Sch\"{o}nlein$ 자반증의 역학 및 임상양상)

  • Kim Se-Hun;Lee Chong-Guk
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.166-173
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    • 2003
  • Purpose : The cause and pathogenesis of $Henoch-Sch\"{o}nlein$ purpura has been studied for many years but the results are disappointing. Recently the hypothesis that abnormalities involving the glycosylation of the hinge region of immunoglobulin Al(IgAl) may have an important role in the pathogenesis of $Henoch-Sch\"{o}nlein$ purpura is being approved. $Henoch-Sch\"{o}nlein$ purpura is the most common vasculitis Ihat affects children and the prognosis is good. But if kidney invovement occurs, the course may be chronic and troublesome. So we evaluated children with $Henoch-Sch\"{o}nlein$ purpura especially from the point of epidemiology and clinical manifestations. Methods : Investigation of 124 children who were diagnosed with $Henoch-Sch\"{o}nlein$ purpura at Inje University Ilsan Paik Hospital from December 1999 to July 2003 was performed retrospectively through chart review. Efforts were made to get informations about the profile, epidemiology, clinical manifestations, progress of the disease and recurrence rate of patients. Results : The patients were 69 boys and 55 girls, with a mean age of $6.1{\pm}2.7$ years at the time of data collection. The male to female ratio was 1.25 : 1. The occurrence rate was much higher in autumn(from September to November, 31.5%) and winter(from December to February, 28.2%) than in spring and summer, with a peak in November. Joint involvement was shown in 66.9% of patients mostly on the foot/ankle(75.9%), knee(39.8%). Seventy(56.5%) out of 124 patients had abdominal pain and 10 patients(8.1%) showed bloody stools. Renal involvement was observed in 24 patients(19.4%) after 21.1 days on the average. IgA was elevated in 10 of 21 patients(47.6%). $C_3$ and $C_4$ levels were normal in 40 of 49 patients (81.7%) and 47 of 48 patients(97.9%), respectively Antistreptolysin-O(ASO) titer was elevated over 250 Todd units in 29 of 62 Patients(46.8%). Mycoplasma antibody titer was elevated in 21 of 49 patients(42.9%) equal or greater than 1:80. Radiologic studies were peformed in 23 patients. Seven patients(30.4%) showed bowel wall thickening and one of them received intestinal resection and anastomosis operation due to terminal ileum necrosis. Eighty four patients took steroid 1.4 mg/kg/day in average. Recurrence rate was 2.5 in 37 patients(29.8%). Conclusion : $Henoch-Sch\"{o}nlein$ purpura in childhood appears most in about 6 years of age. The occurrence rate is much higher in autumn and winter relatively. Diagnosis can be made through the perspective history taking and the inspection of clinical manifestations, but the laboratory findings are not of great help. A small portion of the patients might show abdominal pain or arthritis before purpura develops, therfore various diagnosis can be made. Radiologic evaluation should be performed to avoid surgical complications in cases accompanying abdominal pain, and long term follow up should be needed especially in patients suffering from kidney involvement. In about 30% of the patients $Henoch-Sch\"{o}nlein$ purpura would recur. Steroid can be used safely without side effects.

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Human Infections by Heterphyes heterophyes and H. dispar Imported from Saudi Arabia (사우디아라비아에서 감염된 이형이형흡충(Heterophues heterophues) 및 H. dispar 증례보고)

  • 채종일;서병설
    • Parasites, Hosts and Diseases
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    • v.24 no.1
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    • pp.82-88
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    • 1986
  • Two human cases of Heterophyes heterophyes and H. dispar infections were proven by the recovery of their adult worms. The cases were 38-year and 40-year old Korean workers who had been in Saudi Arabia for 4~6 years and returned home in 1983 or 1984 with gastrointestinal troubles. In Saudi Arabia they had eaten raw brackish water fishes such as the mullet. After the treatment with 10 mg/kg praziquantel and purgation with magnesium salt, a total of 19 specimens of H. heterophyes and 140 of H. dispar were collected. It is of interest that the worms persisted in a patient although he had been back in Korea for 14 months. This is the first report on imported heterophyiasis in Korea. Human infection by H. dispar is the first record in the literature.

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A human case of invasive fascioliasis associated with liver abscess (간질증 초기 침습기에 발견된 간농양 예)

  • KIM, Jin-Bong;KIM, Dong-Joon;HUH, Sun;CHO, Seung-Yull
    • Parasites, Hosts and Diseases
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    • v.33 no.4
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    • pp.395-398
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    • 1995
  • A 56 year-old Korean housewife/farmerlgoat keeper suffered from right upper quadrant pain and fever with chills. In the abdominal sonogram and computerized tomography, multiple, 2-3 cm, irregular shaped cavities were observed in the right lobe of liver. A liver biopsy revealed extensive central necrosis with Characot-Leyden crystals surrounded by palisading histiocytes, eosinophil-rich inflammatory infiltration. Worm was not observed. However, the serologic test for Fusciola-specific IgG antibody by micro-ELISA was positive. Prior antibody levels did not differ and eosionophilia persisted 6 and 16 months after praziquantel treatment although the cavitaxy lesions in the liver disappeared 6 months after the treatment. Reported herein is a human case of invasive fascioliasis diagnosed clinically by a combination of radiological, histopathological and serological studies.

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Persistent Hymen and Pyocolpos in a Female Shih-Tzu Dog (시츄 개에서 발생한 처녀막 잔존증과 질축농증)

  • Kim, Minkyung;Kim, Keun-Yung;Park, Ji-Hun;Shin, Jeong-In;Kim, Tae-Hwan;Hong, Subin;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.246-249
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    • 2014
  • A 9-year-old intact female Shih-Tzu was presented with abdominal pain and abdominal distension. Since the animal's birth, the owner had never observed proestrous bleeding in the patient. Ultrasonography revealed segmental enlargement of the genital system. An ovariohysterovaginectomy was performed to remove the genital mass. The vagina was grossly dilated as a result of being filled with a solid black-green substance. A vaginogram was performed. Based on the surgical findings and vaginogram results, an imperforate hymen was diagnosed. One month from the first surgery, a stump pyocolpos developed between the sutured site and the obstructed portion. The persistent hymen was removed by endoscopy. However, peritonitis and sepsis developed after the procedure, and the dog died. Therefore, During operation of persistent hymen, a cruciate incision over the hymen strongly recommended to avoid additional post operative complications.

Three cases of atypically presented group A streptococcal infections (전형적인 전구 증상 없이 발현된 A군 연구균 감염증 3례)

  • Yeo, Yun Ku;Lee, Eun Hee;Ko, Kwang Min;Jae, Seo Jin;Kim, Tae Yeon;Lee, Jin;Kim, Yun Kyung
    • Pediatric Infection and Vaccine
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    • v.14 no.1
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    • pp.104-110
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    • 2007
  • Streptococcus pyogenes, which is classified to Group A streptococcus (GAS), is one of the most common bacterial pathogens of the childhood infection. This organism can cause acute bacterial pharyngitis, impetigo, peritonsilar abscess or scarlet fever. It can also cause severe invasive diseases such as toxic shock syndrome, sepsis, septic arthritis, necrotizing pneumonia or necrotizing fasciitis. Usually, invasive GAS infections are accompanied by systemic symptoms and signs. Necrotizing pneumonia presents with acute fever, pleuritic chest pain and cough. The progress of disease is usually rapid and typically, pleural effusion develops in the early course of disease. Necrotizing fasciitis is relatively rare but once it has developed, it may be life threatening and cause necrosis of adjacent soft tissues with rapid progress. Clinical manifestations of parapharyngeal abscess are fever, dysphagia or bulging of pharyngeal wall. We experienced three cases of GAS infections which were presented atypically.

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A Case Report of Patient with Alcoholic Derogation Acute Abdominal Pain Using Oriental Medicine Combined with Conventional Treatment (한양방 협진 치료를 통해 호전을 보인 주상(酒傷)으로 인한 급성 복통 환자 1례)

  • Kim, Sang-Bom;Park, Jae-Woo;Cho, Chong-Kwan;Lee, Yeon-Weol;Yoo, Hwa-Seung
    • Journal of Haehwa Medicine
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    • v.21 no.1
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    • pp.79-85
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    • 2012
  • Objective : This study was aimed to report a patient accompanied by alcoholic derogation acute abdominal pain treated with oriental medicine combined with conventional treatment. Methods : A 36 year old female patient complained of acute abdominal pain for one year from Apr. 2009. She had treated at local general hospital. But the symptom was not reduced. Instead, it was aggravated on Jul. 2010. The main symptoms were left flank pain, chest discomfort, nausea and anorexia. The patient was treated by oriental medicine (herbal medicine (Chunggan-plus), acupuncture, moxibustion, etc) combined with conventional medicine from Jul. 10th, 2010 to Jul. 17th, 2010. We observed the patient with evaluation of laboratory test and imaging scan. Results : Most of the symptoms of the patient were improved. Especially, the abdominal pain were disappeared from grade 3 to grade 0. No side effects were noted during treatment. Conclusion : This results suggest that the oriental medicine combined with western medicine may effective to treat alcoholic derogation acute abdominal pain.

A Case Report of Korean Medicine Treatment for a Patient with Functional Abdominal Pain (한의약 치료 후 호전된 기능성 복통 환자 치험 1례)

  • Kim, Hakkyeom;Kim, Youngji;Song, Juyeon;Moon, Jiseong;Min, Seonwoo;Ahn, Lib;Lim, Seong-woo
    • The Journal of Internal Korean Medicine
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    • v.41 no.5
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    • pp.885-891
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    • 2020
  • Objectives: The aim of this case report was to present the effects of Korean medicine treatment in a patient with functional abdominal pain. Methods: A 24-year-old female patient was treated with Sogeonjung-tang and Gammaekdaejo-tang extract granules with acupuncture therapy. Abdominal pain and soreness were assessed daily with a numeric rating scale (NRS) Results: With 7 days of treatment, abdominal pain was relieved from NRS 7 to NRS 3. By the 6th day of treatment, abdominal soreness had disappeared. Conclusion: These results show that functional abdominal pain can be relieved with Korean medicine treatment. However, further well-designed studies are required to confirm these findings.

Hemorrhagic Bullous Lesions in a 9-year-old Girl with Henoch-Sch$\ddot{o}$lein Purpura (Henoch-Sc$\ddot{o}$lein 자반증에서 출혈성 물집을 동반한 9세 소아 1례)

  • Kim, Moon-Kyu;Park, Sung-Eun;Lee, Jun-Ho
    • Childhood Kidney Diseases
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    • v.16 no.1
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    • pp.51-53
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    • 2012
  • Henoch-Sch$\ddot{o}$nlein purpura (HSP) is the most common vasculitis in children and is characterized by cutaneous purpura, arthritis, abdominal pain, and nephritis. Bullous skin lesions are rare in children. We report a case involving a 9-year-old female with HSP who displayed rapidly evolving hemorrhagic bullae from the primary purpuric lesions during systemic corticosteroid therapy. The bullae disappeared within 7 days of systemic corticosteroid therapy. Some scar lesions of the skin developed on acute phase recovered completely after 6 months. Bullae should not be considered as a poor prognostic factor of HSP and its renal outcome. Skin biopsy in HSP children with bullae is not necessary if clinical diagnostic criteria of HSP are met. However, further evaluation of more pediatric HSP with bullae is needed to get the clearer conclusions. We report a 9-year-old female with HSP who showed the rapidly evolving hemorrhagic bullae from primary purpuric lesions during systemic corticosteroid therapy.

Five Cases of Diphyllobothrium latum Infection (광절열두조충감염 5예)

  • 이순형;서병양
    • Parasites, Hosts and Diseases
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    • v.21 no.2
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    • pp.150-156
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    • 1983
  • Five cases of Diphyllobothrium latum infection were proved by collection of worms after treatment with bithionol, niclosamide or praziquantel, during 1975~1983. The patients were 4 males and one female aged 10~64 years residing in Seoul or Wando-gun, Chollanam-do, Korea. All of them remembered the history of eating several kinds of raw marine fish and 2 persons said they ate the raw mesh of perch, Lateolabrax japcnicus. Three amcnE them experienced abdominal pain, 2 natural discharge of a chain of segments, but none revealed any sign of anemia. The average egg size in stool varied $59~67{\times}41~48{\mu\textrm{m}}$ according to cases. The eggs were characterised by ovoid to elliptical shape, terminal operculum, and distinct abopercular protuberance. One naturally discharged segment (30cm) and 4 complete strobilae (320~680cm) with scolices obtained after treatments were examined. The morphological characters of proglottids such as rosette-form uterus with 3~6 loops, vaginal pore included in the cirrus sac, separated seminal vesicle from cirrus sac, etc. were all compatible with D. latum. These are the 7th~11th cases of D. latum infection proved by worms in Korea.

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A Case of Lipoprotein Lipase Deficiency in an Infant with Recurrent Pancreatitis (영아기에 반복성 췌장염을 보인 지질단백 지질분해 효소 결핍 1예)

  • Park, Hae-Jin;Choi, Byeong-Sam;Yang, Hye-Ran;Chang, Ju-Young;Ko, Jae-Sung;Shin, Choong-Ho;Yang, Sei-Won;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.79-83
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    • 2009
  • Familial chylomicronemia syndrome is a rare disorder characterized by severe hypertriglyceridemia and fasting chylomicronemia. Causes of the syndrome include lipoprotein lipase (LPL) deficiency, apolipoprotein C-II deficiency, or the presence of inhibitors to LPL. We managed a 3-month-old girl who had recurrent acute pancreatitis caused by chylomicronemia. We report the first case of familial chylomicronemia in Korea caused by LPL deficiency in an infant with recurrent acute pancreatitis.

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