• Title/Summary/Keyword: 신장 침범

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Various Renal Manifestations in Children with Tuberous Sclerosis Complex (소아 결절성 경화증에서 나타나는 다양한 신증상들)

  • Lim, Ja Hyun;Park, Moon Sung;Pai, Ki Soo;Kim, Sung Hwan;Shin, Jae Il;Park, Se Jin
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.132-136
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    • 2014
  • Tuberous sclerosis complex (TSC) is a genetic disorder that affects multiple organ systems and causes tumors. It is important that physicians are aware of the manifestations of TSC, and that they follow the recommendations for screening and evaluation. Several types of renal abnormalities may develop in individuals with TSC. Individuals with TSC may require ongoing treatment that can be adapted for each arising manifestation of renal disease. Herein, we report 4 patients with TSC who presented with a range of different renal manifestations, including angiomyolipoma, renal cell carcinoma, renal infarction, renal cyst, and nephrolithiasis.

Clinical Significance of Gastrointestinal Symptoms and Abdominal Ultrasonographic Findings in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 복부 증상의 임상적 의의와 복부 초음파 소견)

  • Choi, Eun Jung;Lee, Chang Woo;Choi, Du Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.63-67
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    • 2005
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

A Case of the Wegener's Granulomatosis (Wegener씨 육아종)

  • 조정욱;황명순;윤치훈;이상도;김선우
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.13.4-13
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    • 1981
  • The Wegener's granulomatosis is a rare disease of unknown etiology characterized by ulcerative, necrotic lesion of the upper respiratory tract, progressive pulmonary and renal involvement, and death in a period six months. Relentless progression with rapid death resulting from renal involvement and failure is the usual outcome, but limited forms with confinement to the upper respiratory tract are seen. The authors, recently, have observed a case of Wegener's granulomatosis which was confirmed as pathologically, so present this case with a brief review of the literature.

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A Case of Idiopathic Takayasu's Arteritis - Experience of Successful Treatment - (특발성 Takayasu's arteritis - 활동기의 치료경험 1례 -)

  • Na So Young;Kang Hee Gyung;Ha Il Soo;Kim In One;Cheong Hae Il;Choi Yong
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.114-119
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    • 2002
  • Takayasu's arteritis(TA) is a chronic idiopathic vasculitis mainly involving the aorta and its main branches, such as brachiocephalic, carotid, subclavian, vertebral and renal arteries, as well as coronary and pulmonary arteries The clinical features usually reflect limb or organ ischemia resulting from gradual stenosis of involved arteries. We experienced a case of idiopathic Takayasu's arteritis with negative tuberculin test involving multiple main branch arteries at active stage without pulse. We treated this patient with combined therapy of steroid and azathioprine, with remission of disease activity. (J Korean Soc Pediatr Nephrol 2002 ;6 : 114-9)

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Immunoglobulin G4-Related Disease in the Thorax: Imaging Findings and Differential Diagnosis (흉부에서 발생한 IgG4 연관 질환: 영상 소견 및 감별진단)

  • Yookyung Kim;Hye Young Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.826-837
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    • 2021
  • Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory condition involving multiple organs, including the salivary or lacrimal glands, orbit, pancreas, bile duct, liver, kidney, retroperitoneum, aorta, lung, and lymph nodes. It is histologically characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, storiform fibrosis, and obliterative phlebitis. In the thoracic involvement of IgG4-RD, mediastinal lymphadenopathy and perilymphangitic interstitial thickening of the lung are the most common findings. Peribronchovascular and septal thickening and paravertebral band-like soft tissue are characteristic findings of IgG4-RD. Other findings include pulmonary nodules or masses, ground-glass opacity, alveolar interstitial thickening, pleural effusion or thickening, mass in the chest wall or mediastinum, and arteritis involving the aorta and coronary artery. Radiologic differential diagnosis of various malignancies, infections, and inflammatory conditions is needed. In this review, we describe the imaging findings of IgG4-RD and the radiologic differential diagnoses in the thorax.

Different Clinical Courses of Henoch-Schönlein Purpura in Children, Adolescents and Adults (Henoch-Schönlein Purpura에서 연령에 따른 임상 양상 및 예후에 관한 고찰)

  • Hong, Joo Hee;Na, Hyung Joon;Namgoong, Mee Kyung;Choi, Seung Ok;Han, Byng Geun;Jung, Soon Hee;Kim, Hwang Min
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1244-1251
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    • 2005
  • Purpose : $Henoch-Sch{\ddot{o}}nlein$ purpura(HSP) is the most common and benign systemic vasculitis in children. Few reports have focused on worse outcomes of HSP in adults. The age of onset is suggested as a main risk factor. We assessed the characteristics of adolescent-onset HSP. Methods : We retrospectively analyzed 205 cases presented from Aug. 1993 to Oct. 2003. Patients were classified as children(<10 years of age), adolescents(10-20 years of age), and adults(>20 years of age). Results : The mean age was $5.7{\pm}1.8years$ in 149 children, $13.5{\pm}2.4years$ in 38 adolescents, and $44.9{\pm}14.5years$ in 18 adults. The male to female ratio was 1.2 : 1 in children and adolescents, and 2 : 1 in adults. Previous upper respiratory infections were found in 53.4 percent of children, 32.4 percent of adolescents, and 33.3 percent of adults. Positivity of stool occult blood was more frequent in adults(50.5 percent) than in children(23.0 percent)(P<0.05). Renal involvement was found in 46 cases (30.9 percent) of children, 23 cases(60.5 percent) of adolescents, and 15 cases(83.3 percent) of adults. Recurrences occurred in 23 cases(15.4 percent) of children, nine cases(23.7 percent) of adolescents, and three cases(16.7 percent) of adults. Among the cases with renal involvement, 97.8 percent of children and 87.0 percent of adolescents improved to normal or asymptomatic urinary abnormalities. 60.0 percent of adults persisted with severe nephropathy and 13.3 percent progressed to renal insufficiency. Conclusion : Although the outcome of adolescent HSP was as good as children, the clinical manifestations were similar to those of adults. Adolescents had the highest rate of recurrences. Thus long term observations may be needed in adolescent onset HSP.

Avascular Necrosis of Bone after Renal Transplantation - Prevalence and Usefulness of Bone SPECT - (신장 이식후에 발생한 무혈관성 골괴사 -발생 빈도 및 골 SPECT의 유용성에 관하여 -)

  • Choi, Yun-Young;Yang, Seoung-Oh;Ryu, Jin-Sook;Moon, Dae-Hyuk;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.504-510
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    • 1995
  • Avascular necrosis(AVN) of bone can be resulted from various causes that distrub vascular supply to bone tissue, including steroid therapy after renal transplantation. In this study, we determine the prevalence of the avascular necrosis of bone after renal transplantation and compare the role of the bone scan, SPECT and MRI. In 301 patients with transplanted kidney, the prevalence of avascular necrosis was deter-mined clinically. Site of bone necrosis was evaluated by clinical symptom, bone scan, SPECT and MRI. Bone scan was done in all patients with AVN. Bone SPECT and MRI were done in six cases; and MRI was done in two cases. The prevalence of AVN was 3.3% (10/301), and the site of AVN was 16 femoral heads in 10 patients (bilateral: 60%) and bilateral calcaneal tuberosity in one patient. Bone scan showed typical AVN (cold area with surrounding hot uptake) in 13 lesions, only hot uptake in three lesions (including two calcaneal tuberosities), decreased uptake in one lesion, and normal in one lesion. Decreased uptake and normal lesion showed an equivacal cold area without surrounding hot uptake on SPECT. A symptomatic patient with positive bone SPECT showed normal finding on MRI. The prevalence of AVN of bone after renal transplantation was 3.3%, and whole body bone scan showed multiple bone involvement. Two symptomatic hip Joints without definite lesion on whole body bone scan or MRI showed cold defect on SPECT. Therefore, we conclude that bone SPECT should be perfomed in a symptomatic patient with negative bone scan or MRI in case with high risk of AVN after renal transplantation.

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A Case of Diffuse Infiltrative Lymphocytosis Syndrome Associated with Human Immunodeficiency Virus Infection (사람면역결핍바이러스 감염에 동반된 미만성 침윤성 림프구 증가 증후군 1예)

  • Kwon, Sun Ok;Park, Won Wo;Lee, Hyun Kyung;Lee, Sung Soon;Kang, Youn Kyung;Lee, Young Min;Lee, Hyuk Pyo;Kim, Joo In;Choi, Soo Jeon;Yum, Ho Kee
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.289-293
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    • 2006
  • Diffuse infiltrative lymphocytosis syndrome is an autoimmune syndrome that is characterized by the oligoclonal expansion of CD8+ T-lymphocytes in response to human immunodeficiency virus (HIV) antigens. The clinical manifestations include bilateral enlargement of the parotid glands, lymphocytic interstitial pneumonitis, lymphocytic hepatitis, neurological involvement and systemic lymphadenopathies. In addition to a positive HIV test, the diagnostic histopathological findings are CD8+ T-lymphocytic infiltrations in the lymphnodes, liver, lung, muscle and the salivary or lacrimal glands without granulomatous or neoplastic involvement. We report a case of pulmonary involvement of diffuse infiltrative lymphocytosis syndrome that was associated with a human immunodeficiency virus infection.

Focal Bacterial Nephritis (Lobar Nephronia) in a Four- Month Old Boy (국소성 세균성 신염 (Lobar Nephronia) 1례)

  • Ahn Hye Young;Pai Ki-Soo;Oh Seung Hwan;Lee Jin Yong;Kim Pung-Kil;Lee Jae Seung
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.73-77
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    • 2001
  • Acute lobar nephronia is a focal of acute bacterial nephritis, affecting one or more of the renal lobules. Nephronia is being diagnosed more frequently in accordance with the advancing imaging techniques of urinary tract. We report a case of acute nephronia in a 4 month old boy who presented persisting urinary tract infection after intial antibiotic treatment. Ultrasonography and computerized tomography showed round wedge-shaped, non-enhancing mass in right kidney. Gallium scan also revealed the lesion in the right kidney. This lesion resolved completely on one month follow up examinations. (J. Korean Soc Pediatr Nephrol 5 : 73- 7, 2001)

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The Relationship Between Interleukin $1{\beta}$ Gene Polymorphism and Renal Involvement in Henoch-$Sch\ddot{o}nlein$ Purpura (Henoch-$Sch\ddot{o}nlein$ Purpura에서 Interleukin $1{\beta}$ 유전자 다형성과 신장 침범과의 연관성)

  • Na, Hyoung-Joon;Go, Il-Yong;Yoon, Joon-Ho;Yeh, Byung-Il;Kim, Hwang-Min
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.125-131
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    • 2006
  • Purpose : High interleukin-1 beta(IL-$1{\beta}$) expression in the skin biopsy specimens of patients with Henoch-$Sch\ddot{o}nlein$ Purpura(HSP) has been observed. We examined IL-$1{\beta}$ gene polymorphism in patients with HSP. The purpose of this study is to examine the relationship between IL-$1{\beta}$ gene polymorphism and renal involvement in HSP. Methods : Patients from mideast Korea with HSP were studied. All patients had at least 6 months of follow up. Patients and ethnically matched controls were genotyped for IL-$1{\beta}$ gene polymorphism by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). Results : Thirty-four patients(all younger than 15 years old) who had been diagnosed with HSP and 27 controls were examined. No allele or genotype differences between the HSP and control groups were observed. No significant association between the carriage of IL-$1{\beta}$(-511) T allele and renal involvement(P=0.525, OR:1.417, CI:0.545-3.686) was found. Conclusion : In unselected patients with HSP, carriage of IL-$1{\beta}$(-511) T allele does not appear to influence renal involvement.

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