• Title/Summary/Keyword: 자가 면역성 질환

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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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Hyperthyroidism Caused by a Mutation in the Thyrotropin Receptor Gene in Two Brothers (형제에서 발생한 갑상선 자극호르몬 수용체 유전자 돌연변이에 의한 갑상선 항진증 2례)

  • Kim, Jae Hyun;Lee, Sung Soo;Lim, Jung Sup;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.337-341
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    • 2005
  • Thyrotropin receptor(TSHR) mutations must be considered when congenital hyperthyroidism has persisted, but there has been no evidence for autoimmunity. TSHR mutations leading to constitutive activation of the thyroid gland were identified as the molecular cause of autosomal dominant nonautoimmune hyperthyroidism and sporadic congenital hyperthyroidism. We report two cases of hyperthyroidism caused by germline TSHR mutation who presented with exessive sweating and no evidence of autoimmune thyroid disease. They were brothers and their mother had undergone thyroidectomy because of hyperthyroidism. Direct sequencing of the polymerase chain reaction-amplified exon 10 of the TSHR genomic DNA revealed a transition of GCT to GTT, resulting in an exchange of alanine 627 to valine in the patients and their mother. This might be a novel mutation or polymorphism, but we did not perform any functional gene study. But considering the clinical profiles, we can conclude that hyperthyroidism of these two brothers might come from the point mutation described above.

The Changes in Serum TSH-Binding Inhibiting Immunoglobulin (TBII) Activity and Thyroglobulin Level after Treatment with Radioactive Iodine ($^{131}I$) in Graves' Hyperthyroidism (그레이브스 갑상선기능항진중 환자에서 방사성 옥소($^{131}I$) 투여 후 혈청 갑상선자극 면역글로불린 (Thyrotropin-Binding Inhibiting Immunoglobulin, TBII)활성도 및 Thyroglobulin의 변화)

  • Son, Tae-Yong;Lim, Sang-Moo;Hong, Sung-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.200-205
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    • 1994
  • 그레이브스 갑상선기능항진증은 자가면역질환의 하나로 방사성 옥소가 간편하고 경제적이며 효과적인 치료법임이 알려져 있는데 방사성 옥소 투여 후 갑상선 조직의 자극 및 파괴에 따라 각종 항원의 노출의 증가와 이에 대한 자가항체의 변동이 예상된다. 저자들은 추정 갑상선 무게를 고려한 6-10 mCi의 방사성 옥소를 투여 받은 그레이브스 갑상선기능항진증 환자 90명을 2년간 추적하여 치료 전 후의 혈청 갑상선자극 면역글로불린(TBIIl)활성도와 thyroglobulin 및 antithyroglobulin antibody의 변화를 관찰하였다. 1) 대상환자 90명의 연령분포는 14-58세(중앙치 30)였으며 여자가 72명(80%)이었다. 2) 평가대상 환자 중 치료 전 TBIIl 활성도가 정상범위였던 경우는 15명(30%)이었고 증가된 경우는 35명(70%)이었다. 치료 전보다 치료 3개월 후에 TBII 활성도가 더 증가된 경우는 31명(62% )이었다. 3) TBII 활성도가 치료 전에 증가하였거나, 치료 전에 정상범위였다가 치료 3개월 후에 증가한 환자의 TBII 활성도의 동태는 치료 3개월 후에 가장 높았고 그 후 점차 감소하였다. 이들의 TBIIl 활성도가 15%이내로 정상화된 정도는 치료 후 6개월에 40%, 12개월에 82%였다. 4) 치료 전 antithyroglobulin antibody가 양성인 경우 80%에서 3개월 후에도 혈청 thyroglobulin의 동태는 치료 3개월 후에 높았다가 증가가 없었으며 치료 전 antithyroglobulin antibody가 음성인 경우 60%에서 치료 3개월 후에 혈청 thyroglobulin의 증가가 있었다. 5) antithyroglobulin antibody가 음성인 경우의 혈청 thyroglobulin의 동태는 치료 3개월 후에 높았다가 점차 감소하는 경향을 보였으며 antithyroglobulin antibody가 양성인 경우의 혈청 thyroglobulin의 동태는 치료 후 시간이 지남에 따라 점차 감소하였다. 6) 치료 전 antithyroglobulin antibody가 음성인 경우 치료 후 시간 경과에 따라 동시에 측정한 혈청 TBII 활성도와 thyroglobulin 사이에는 통계적으로 유의한 상관관계가 있었다(p<0.01). 한편 치료 전 antithyroglobulin antibody가 양성인 경우 치료 후 시간 경과에 따라 동시에 측정한 혈청 TBII 활성도와 thyroglobulin 사이에는 통계적으로 유의한 상관관계가 없었다(p= 0.16). 이상의 결과로 방사성 옥소를 투여 받은 그레이브스 갑상선기능항진증 환자에서 혈청 TBII 활성도는 항갑상선제를 투여 받은 경우와는 달리 초기에 증가하였다가 시간이 지남에 따라 점차 감소함을 알 수 있었으며 그 감소 정도는 항갑상선제만을 쓴 경우보다 더 빠를 것으로 생각된다. 따라서 혈청 TBII 활성도와 thyroglobulin은 방사성 옥소 치료효과의 관찰에 중요한 역할을 할 것으로 생각되며 특히 antithyroglobulin antibody가 음성인 경우 혈청 thyroglobulin은 혈청 TBII 활성도를 반영할 것으로 사료된다.

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Familial systemic lupus erythematosus in two Korean male siblings (형제에서 발병한 가족성 전신 홍반 루푸스)

  • Kang, Hyun Sik;Oh, Hyun Ju;Kim, Young Ree;Kim, Jae-Wang;Shin, Kyung-Sue
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.611-614
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    • 2009
  • Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease characterized by the production of a wide range of autoantibodies, resulting in tissue damage. Although the susceptibility to SLE has been attributed to complex interactions between genetic and environmental factors, the influence of a genetic predisposition to SLE is supported by observations of familial aggregations. Family studies have found that siblings with an SLE-affected relative have a 20-fold higher risk of developing SLE compared with the general population. Here, we present a rare case of two male siblings with SLE. The clinical, laboratory, and histopathological findings of these individuals showed the characteristic features of SLE. Human leukocyte antigen (HLA) typing revealed that the brothers and their mother shared the common HLA haplotype of DRB1*1501 and DQB1*0602, which is significantly associated with disease susceptibility in both family-based and casecontrol studies. This report provides an opportunity to reveal the role of genetic factors in the development of SLE.

A case of idiopathic pulmonary hemosiderosis with seasonal recurrence (계절성으로 재발한 특발성 폐 혈철 침착증 1예)

  • Kwak, Ga Young;Lee, Na Young;Lee, Moon Hee;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.256-260
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    • 2009
  • Idiopathic pulmonary hemosiderosis (IPH) is a rare disease affecting mostly children. This disorder is characterized by recurrent episodes of hemoptysis, bilateral diffuse pulmonary infiltrates, and iron-deficiency anemia. An acute fulminant alveolar hemorrhage can be fatal due to respiratory failure, while chronic hemorrhage leads to hemosiderin-laden macrophages and pulmonary fibrosis. Genetic, autoimmune, allergic, environmental, and metabolic mechanisms of pathogenesis have been suggested, but the etiology of IPH remains unknown. We report on a 9-year-old girl with idiopathic pulmonary hemosiderosis who showed seasonal recurrences without cause.

Development of Exposure Biomarkers for Endocrine Disrupting Chemicals Using DNA Microarray (DNA 마이크로어레이를 이용한 내분비장애물질 노출지표 개발)

  • Yang, Mi-Hi
    • Environmental Analysis Health and Toxicology
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    • v.20 no.4 s.51
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    • pp.327-332
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    • 2005
  • 장기간 노출 시 발암 등 인체 유해성을 갖는 환경유래 내분비장애물질(endocrine disrupting chemicals, EDCs)에 대한 선택적이고 민감한 노출지표를 개발하기 위하여 본 연구에서는 DNA microarray를 이용하였다. 피험자는 아직 특별한 질환을 갖지 않는 18세 이상 연령, 성을 맞춘 EDCs고농도 노출군(N = 16)과 저농도군(N = 16)으로 구성되었다. 노출정도 구분은 10년 이상 거주지가 K산업폐기물 소각장과 2.5 km 반경 내, 외 인지에 따라 고노출군,저노출군으로 구분하였다. 피험자의 말초혈에서 total RNA를 분리, 각 군당 B인씩 pool로 cDNA를 합성하여 oligonucleotide DNA 칩에 적용하였다. 유전자발현의 차이를 GenePixPro 4.0 software를 이용하여 분석하였다. 총 3장의 칩을 이용하여 공통적으로 저노출군보다 고노출군에서 2배 이상 발현의 증가를 보인 유전자는 plasminogen activator(PLAT)등 12종이 관찰되었고, l/2이하로 발현의 감소를 보인 유전자는 kallikrein 3 (KLK3)등 29종이었다. 이 들 유전자는 PLAT등 면역계 반응에 관여하는 유전자 및 apoptosis, transport, G protein, chromatin, 암화, 발생 (development), 대사 등에 관여하는 유전자들이었다. 그러므로 KLK3등 본 연구에서 발굴한 유전자는 향후 확대된 인구에서 본 연구 결과의 확인을 통하여 EDCs특이적 노출지표로써, 나아가 암 등 EDCs관련 질병의 기전 및 병인학을 구명하는데 이용가치가 높다고 사료된다.

A case of childhood relapsing/remitting multiple sclerosis and interferon β-1b treatment in a Korean patient (소아 재발/완화형 다발성 경화증 환자에서 인터페론 베타 1b 치료 1례)

  • Kim, Hyun Seok;Lee, Won Deok;Lee, Jun Hwa;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.580-584
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    • 2007
  • Multiple sclerosis (MS) is a demyelinating disorder that affects discrete areas of the CNS, including the optic nerves, in a quite variable relapsing-remitting fashion over a prolonged period of time. Although MS is usually considered to be a disease that affects peoples in early to middle adulthood, children do develop multiple sclerosis. The frequency of MS onset before the age of 15 years is 2.7-5% of all cases, while MS onset during infancy and early childhood was observed to be 0.2-0.7% of all cases. We report here on a Korean case of a relapsing-remitting MS female child who was treated with four rounds of intravenous methylpredinsolone pulse therapy and preventive Interferon-$\beta$-1b ($Betaferon^{(R)}$).

Comparison of Neural Cell Differentiation of Human Adipose Mesenchymal Stem Cells Derived from Young and Old Ages (연령별 지방 중간엽 유래 줄기세포의 신경세포로의 분화 능력 비교)

  • Jo, Jung-Youn;Kang, Sung-Keun;Choi, In-Su;Ra, Jeong-Chan
    • Development and Reproduction
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    • v.13 no.4
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    • pp.227-237
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    • 2009
  • Recently, adipose mesenchymal stem cells (AdMSC) that are similar to bone marrow MSC and blood derived MSC are thought to be another source for stem cell therapy. However, the diseases that can be applied for stem cells therapy are age-dependent degenerative diseases. Accordingly, the present study investigated the growth and differentiation potential to neural cells of human AdMSC (hAdMSC) obtained from aged thirty, forty and fifty. The growth of cells and cell viability were measured by passage and neural differentiation of hAdMSC was induced in neural differentiation condition for 10 days. Our results demonstrated that cell number, viability and morphology were not different from hAdMSC by age and passage. Immunofluorescence analysis of neural cell marker (TuJ1, NSE, Sox2, GFAP or MAP2) demonstrated no significant differences in neural cell differentiation by age and passage. As the number of passage was increased, the mRNA level of MAP2 and Sox2 was decreased in hAdMSC from age of 50 compared to hAdMSC from age of 30. In conclusion, the present study demonstrated that ability of neural cell differentiation of hAdMSC was maintained with ages, suggesting that autologous stem cells from aged people can be applied for stem cell therapy with age-dependent neural disease with the same stem cell quality and ability as stem cell derived from young age.

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Evaluation of Antibodies Against Haemophilus influenzae Type b in Korean Adults (우리나라 성인에서 Haemophilus influenzae type b에 대한 항체 평가)

  • Lee, Ji Hyen;Kim, Han Wool;Lee, Soyoung;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.125-133
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    • 2017
  • Purpose: After the introduction of Haemophilus influenzae type b (Hib) vaccine in 1995 in Korea, it was included in the national immunization program in 2013. In the post-Hib vaccine era, some studies in other countries reported that invasive Hib disease affects adults, especially the elderly and immunocompromised persons, more often than it affects children. To evaluate disease susceptibility, quantitative and qualitative analysis of anti-polyribosylribitol phosphate (PRP) antibodies were carried out in Korean adults aged 20 to 85 years. Methods: Sera were collected from 39 healthy adults (20 to 50 years of age) and from 30 elderly adults (75 to 85 years of age) who did not have immune-compromising conditions. The concentration of anti-PRP immunoglobulin G (IgG) and serum bactericidal indices (SBIs) were measured by enzyme-linked immunosorbent assay and serum bactericidal assay. Results: Geometric mean concentrations of anti-PRP IgG and geometric mean SBIs were $0.88{\mu}g/mL$ (95% confidence interval [CI], 0.17 to 3.85) and 354 (95% CI, 50 to 2,499) in young adults and $1.67{\mu}g/mL$ (95% CI, 0.53 to 5.24) and 449 (95% CI, 146 to 1,376) in elderly adults, respectively. When the threshold of seropositivity for anti-PRP IgG was applied as 0.15 or $1.0{\mu}g/mL$, which is the protective antibody level in children, seropositive rates were 87.2% or 53.8% in young adults and 100% or 60% in elderly adults. The seropositivity rates of the SBI ($SBI{\geq}4$) were 82.1% and 100% in the groups, respectively. Conclusions: Most subjects in the adult and elderly adult groups display immunity to Hib based on quantitative and qualitative antibody levels, but not all. Because high immunization and low Hib circulation rates may reduce the natural Hib immunity in the population, monitoring Hib immunity as well as disease are needed continuously.

Nocardia Brain Abscess Mimicking a Metastatic Brain Tumor: A Severe CNS Infection Requiring Aggressive Management (전이성 뇌암으로 오인된 노카디아 뇌농양: 적극적 치료를 요하는 심각한 중추신경계 감염병)

  • Lee, Aleum;Kim, Hee Kyung
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.50-54
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    • 2013
  • Nocardiosis is an uncommon Gram-positive bacterial infection caused by aerobic actinomycetes in the genus Nocardia. Nocardia spp. have the ability to cause localized or systemic suppurative disease in humans and animals. Nocardiosis is typically regarded as an opportunistic infection, but approximately one-third of infected patients are immunocompetent. We report a rare case of pulmonary nocardiosis and a brain abscess caused by Nocardia asteroides in an elderly woman with a history of Crohn's disease. Radiographic imaging revealed a contrast-enhancing lesion with perilesional parenchymal edema that was preoperatively thought to be a neoplasm. The patient experienced aggressive disease progression simulating a metastatic brain tumor. Early diagnosis of norcadiosis, the absence of underlying disease, and the administration of appropriate antibiotics has a positive impact on prognosis. Familiarity with the magnetic resonance and computed tomography findings associated with CNS nocardiosis, such as those presented here, is essential for making an early diagnosis.