• Clinical and Experimental Reproductive Medicine
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• 제31권3호
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• pp.149-154
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• 2004

Objective: To assess the association with autoimmune endocrine diseases and detection rate of autoimmune antibodies and its clinical significance in patients with premature ovarian failure. Methods: Twenty eight patients with primary or secondary amenorrhea manifesting hormonal and clinical features of premature ovarian failure (primary POF: 7, secondary POF: 21) were investigated. We tested them TFT, 75 g OGTT, ACTH and S-cortisol for thyroiditis, IDDM, Addison's disease, and antithyoglobulin antibody, antimicrosomal antibody, antinuclear antibody, rheumatic factor, anti-smooth muscle antibody, anti-acetylcholine receptor antibody for non-organ specific autoimmune disorders. Results: Only one patient was diagnosed as IDDM and no patients had abnormal TFT or adrenal function test. More than one kind of autoantibody was detected in 11 patients of all (39.2%): 5 patients (71.4%) of primary POF group and 6 patients (21.4%) of secondary POF group. Eleven patients (39.3%) had antithyroglobulin antibody, 4 (14.3%) had antimicrosomal antibody, 2 (7.1%) had antinuclear antibody, 2 (7.1%) had rheumatic factor, 1 (3.6%) had anti-smooth muscle antibody, 1 (3.6%) had anti-acetylcholine receptor antibody. Conclusions: Premature ovarian failure may occur as a component of an autoimmune polyglandular syndrome, so patients should be measured with free thyroxine, thyroid-stimulating hormone, fasting glucose and electrolytes. Measurement of thyroid autoantibodies in POF patients may be important in identifying patients at risk of developing overt hypothyoidism, but other autoantibodies may not be suitable for screening test.

• 대한수의학회지
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• 제56권1호
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• pp.47-49
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• 2016

An 11-year-old, spayed female poodle presented with fever and shifting lameness. Physical examination revealed hyperthermia ($40.6^{\circ}C$), and proteinuria was detected upon urinalysis. Increased neutrophils (83%) and decreased viscosity were revealed upon synovial fluid analysis. Serum antinuclear antibody was positive at 1 : 80. Based on these findings, the dog was diagnosed with systemic lupus erythematosus. Immunosuppressive therapy was initiated with prednisolone and cyclosporine, and the condition was markedly improved after the treatments. This case report describes the clinical and laboratory findings, imaging characteristics and successful outcomes after prednisolone plus cyclosporine therapy in a canine systemic lupus erythematosus case.

• Journal of Yeungnam Medical Science
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• 제27권1호
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• pp.78-84
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• 2010

Adult-onset Still's disease (AOSD) is an inflammatory disorder that's characterized by daily, spiking high fever, arthritis and an evanescent, salmon-pink rash. AOSD is diagnosed purely on the basis of the typical clinical features of the illness. The symptoms commonly include swelling of the lymph nodes, enlargement of the spleen and liver, and a sore throat. AOSD is difficult to differentiate from systemic lupus erythematosus (SLE) due to the similar clinical manifestations. We report here on a case of a 16-year-old female patient with autism and epilepsy and who complained of daily spiking fever for 20 days. The patient had maculopapular skin rashes on the face and whole body and lymphadenopathy. The liver function tests were elevated mildly. The initial rheumatoid factor (RF) and antinuclear antibody (ANA) tests were negative. We diagnosed her as having adult-onset Still's disease according to the criteria of Yamaguchi. We successfully treated her with oral prednisolone. But her antinuclear antibody test was changed to positive after discharge. So we finally diagnosed her as having SLE.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.350-358
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• 1998

Antiphospholipid antibody syndrome(APS) is a well-known clinical syndrome characterized by recurrent arterial or venous thromboses, recurrent fetal loss, thrombocytopenia, together with high titers of sustained anticardiolipin antibody(aCL) or lupus anticoagulant(LA). Although systemic lupus erythematosus(SLB) and APS may coexist, a high proportion of patients manifesting the APS do not suffer from classical lupus or other connective tissue disease. The patient has been defined as having a primary antiphospholipid antibody syndrome. We experienced one case of primary APS with recurrent fetal loss, recurrent cerebral infarctions, positive anticardiolipin antibody IgG and fluttering vegetation on the mitral valve, without other connective tissue diseases including SLE. Forty-three old female had 2 out of 11 criteria for the diagnosis of SLE, such as thrombocytopenia and positive antinuclear antibody, but did not meet whole criteria. The patient was treated with ticlopidine, and anticoagulant therapy was recommended.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제10권2호
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• pp.215-220
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• 2007

저자들은 자가면역 질환이 없는 건강한 소아가 황달을 동반하지 않는 급성 복통으로 내원하여 혈청 amylase, lipase의 지속적인 상승과 혈청 IgG 증가, 자가항체(ANA, ANCA) 양성, 방사선 영상에서 췌장 실질종대와 췌장 미부 주췌관의 불규칙적 협착으로 자가면역성 만성 췌장염으로 진단받고 스테로이드와 azathioprine을 경구 복용하였으며 미부 주췌관 협착의 풍선확장술을 시행하고 회복된 1예를 경험하였기에 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제57권4호
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• pp.202-205
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• 2014

Lupus anticoagulant-hypoprothrombinemia syndrome (LAHPS), a very rare disease that is caused by the presence of antifactor II antibodies, is usually counterbalanced by the prothrombotic effect of lupus anticoagulant (LAC). Patients with LAHPS are treated using fresh frozen plasma, steroids, immunosuppressive agents, and immunoglobulins for managing the disease and controlling hemorrhages. Notably, steroids are the important treatment for treating hypoprothrombinemia and controlling the bleeding. However, some patients suffer from severe, life-threatening hemorrhages, when factor II levels remain very low in spite of treatment with steroids. Here, we report a case of LAHPS in a 15-year-old girl who experienced pulmonary hemorrhage with rapid progression. She was referred to our hospital owing to easy bruising and prolonged bleeding. She was diagnosed with LAHPS that presented with pancytopenia, positive antinuclear antibody, proloned prothrombin time, activated partial thromboplastin time, positive LAC antibody, and factor II deficiency. Her treatment included massive blood transfusion, high-dose methylprednisolone, vitamin K, and immunoglobulin. However, she died due to uncontrolled pulmonary hemorrhage.

• Clinical and Experimental Pediatrics
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• 제58권7호
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• pp.267-269
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• 2015

Antithymocyte globulin (ATG) is used as an immunosuppressive treatment (IST) to deplete clonal suppressor T cells in patients with severe aplastic anemia (SAA). The depletion of suppressor T cells by ATG may affect the activation of B cells, which results in an increased risk for autoimmune conditions. A 12-year-old boy was diagnosed with idiopathic SAA. As he did not have an human leukocyte antigen-matched sibling, he was treated with rabbit ATG (3.5 mg/kg/day for 5 days) and cyclosporine. Five months later, he became transfusion independent. However, 23 months after IST, he complained of mild hand tremors, sweating, weight loss, palpitations, and goiter. Results of thyroid function tests revealed hyperthyroidism (free thyroxine, 3.42 ng/dL; thyroid stimulating hormone [TSH], <0.01 nIU/mL; triiodothyronine, 3.99 ng/mL). Results of tests for autoantibodies were positive for the antimicrosome antibody and TSH-binding inhibitory immunoglobulin, but negative for the antithyroglobulin antibody and antinuclear antibody. He was treated with methimazole, and his symptoms improved. The patient has been disease free for 39 months after IST and 9 months after methimazole treatment. This case report suggests that although rare, rabbit ATG may have implications in the pathogenesis of autoimmune hyperthyroidism. Our findings suggest that thyroid function tests should be incorporated in the routine follow-up of SAA patients treated with ATG.

• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1217-1221
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• 2008

목 적: SLE에서는 진단 당시 및 경과 중에 약 15-20%에서 혈소판 감소가 발생하며, 5-16%에서는 혈소판 감소증이 첫 임상증상으로 발생할 수 있으므로 소아 ITP와 SLE와의 연관성이 강력히 제기되고 있다. 한편 항핵항체는 여러 자가면역질환의 선별검사로 주로 이용되고 있는데, 특히 자가면역질환의 임상증상이 발현되기 수개월 혹은 수년 전에 발현될 수 있다. 따라서 저자들은 소아 ITP로 진단된 환자들에서 항핵항체 검사의 양성률 및 임상적 의의를 조사하고자 본 연구를 시작하였다. 방 법: 2003년 1월부터 2006년 12월까지 부산대학교병원 소아청소년과에서 급성 ITP로 진단 받고, 진단 당시에 항핵항체 검사를 시행하였던 77예의 환아를 대상으로 하였다. 항핵항체 검사는 정량 및 정성 검사를 시행하였고, 1:40 이상을 양성으로 판정하였다. 항핵항체 검사 상 양성인 환자들은 1년 이상 역가를 주기적으로 추적관찰 하였다. 결 과: 1) 진단 당시 항핵항체 검사를 시행한 77예의 ITP 환자 중 남아는 38예(49.4%), 여아는 39예(50.5%)였으며, 평균 연령은 4.5세였고, 16예(20.8%)에서 항핵항체 검사 상 양성을 보였다. 2) 항핵항체 양성인 군에서 항핵항체의 정량 역가의 분포는 1:80-1:1,280으로 1:640이 16명 중 5명(30.7%)으로 가장 많았고, 항핵항체의 형은 homogeneous 형이 16명 중 6명(37.5%)으로 가장 많았다. 3) 항핵항체가 양성인 군의 평균 연령은 9.3세로 음성인 군의 3.3세에 비해 진단 당시 평균 연령이 의미 있게 높았다(P<0.05). 4) 항핵항체가 음성인 군의 남녀비는 비슷하였던 반면 항핵항체가 양성인 군은 여아가 81.3%로 현저히 높았다(P<0.05). 5) 진단 당시 혈소판 정중값은 항핵항체 양성군에서는 $18,400/{\mu}L$, 음성군에서는 $21,800/{\mu}L$으로 두 군 사이에 의미 있는 차이가 없었다. 6) 진단 당시 항핵항체의 역가 및 형은 만성 ITP 및 SLE로의 진행과 의의있는 관련이 없었다. 7) 급성 ITP 진단 당시 항핵항체 양성이었던 환자 중 1명이 추적관찰 41개월 후 SLE로 최종 진단되었다. 결 론: 소아 급성 ITP 환자에서 ANA 양성인 경우가 비교적 흔한 것으로 나타났으며, 만성 ITP와 SLE로의 진행에 대한 연관성은 더 많은 환자를 대상으로 한 연구를 통하여 밝혀져야 할 것이다.

• 대한수의학회지
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• 제46권4호
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• pp.395-398
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• 2006

A 2-month-old female Shih-tzu dog was referred because of lameness, exercise intolerance, depression, elbow and stifle joint swelling. Physical examination, complete blood counts, serum-chemistry, radiography, synovial fluid analysis, antinuclear antibody test, and rheumatoid factor measurement were initiated. On radiography, soft tissue swelling of elbow and stifle joints without erosiveness were founded. The results of synovial fluid analysis revealed severe neutrophilic pleocytosis (nondegenerative), decreased viscosity, increased turbidity, positive on mucin-clot test, and negative on bacterial culture. The results of rheumatoid factor measurement and antinuclear antibody test were negative and below 1 : 40, respectively. Based on all tests, we diagnosed this case as juvenile onset type I immune-mediated polyarthritis. Azathioprine (1 mg/kg body weight, per os q 24 h, for 4 weeks) was then administered and clinical signs improved gradually. Four weeks after azathioprine administration, clinical signs were disappeared. This report describes the clinical findings, imaging characteristics, synovial fluid findings, and other laboratory results of type I immune-mediated polyarthritis and successful management with azathioprine therapy.

• 한국임상수의학회지
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• 제17권2호
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• pp.443-449
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• 2000

A three-year-old male jindo with generalized skin lesions (including seborrhea, hyperk- eratosis, alopecia, papules, and ecchymoses), pruritus lymph node enlargement, and fever was brought to Veterinary Teaching Hospital, College of Veterinary Medicine, Chungbuk National Uni- versity. There were no laboratory findings for parasites and fungi in the hair and skin But, the com- plete blood counts (CBC) showed leukocytosis and severe cosinophilia, It was suspected to be an inflammatory and allergic dermatitis. Thus, prednisoIone (0.5 mg/kg PO, BID for 1 week) and ampi- cillin (10 mg/kg PO, BID for 1 week given. One week later, pruritus and ecchymoses were reduced. These treatments were repeated for 7 day again. Three months later, the dog was presented again due to the relapse and exacerbation of the clinical signs. The signs were as follows; severe pru- ritus, vesicobullous skin lesions, anorexia, emaciation, lameness, and welling of carpal joints that showed inflammatory skin lesion and draining of synovia-like fluid. The values of WBC counts were returned to normal ranges. In contrast, eosinophilia was still observed. Coombs test for patient RBC and serum were negative. Hypoalbuminemia (2.5g/dl) was shown by serum chemistry. The uri- nalysis revealed and presence of leukocytes. Luxation finding of right radial carpal joint by polyarthritis was shown in radiography of affected joints.Lupus eryhematosus(LE) cells also appeared in peripheral blood and synovial fluid of affected joints. Definitely, antinuclear antibody (ANA) of patient serum using feline peripheral blood mononuclear cells was detected by all immu- nofluorescence. Based on these findings such as sedum ANA-Positive. major signs (skin disease, non- erosive polyarthritis with soft tissue swelling. and proteinuria), minor signs (fever), and LE cell-pos- itive, a diagnosis of systemic lupus crythematosus (SLE) was mad\ulcorner in this dog. The dog with SLE was administered with Pre(2.0 mg/kg PO, BID for first 4 week and then QOD) to inhibit the production of autoantibodies and with ampicillin (10 mg/kg PO, BID for first 4 weeks and then QOD) to prevent the secondary infection. The condition of this dog was monitored every 2 weeks by physical examinations, radiography, CBC, serum chemistry and urinalyais. At 8th week of treat- ment, the state of SLE evaluated by physical examinations and laboratory findings was markedly improved except for proteinura.