• 제목/요약/키워드: Corticosteroid

검색결과 388건 처리시간 0.089초

스테로이드 치료에 반응하지 않는 심한 위장관 증세의 Henoch-Schönlein 자반증 환아에서 정맥 면역글로불린 치료 (Intravenous immunoglobulin for severe gastrointestinal manifestation of Henoch-Schönlein purpura refractory to corticosteroid therapy)

  • 양혜란;최원정;고재성;서정기
    • Clinical and Experimental Pediatrics
    • /
    • 제49권7호
    • /
    • pp.784-789
    • /
    • 2006
  • 목 적 : HSP는 피부, 관절, 위장관, 신장을 포함한 전신의 소혈관을 침범하는 혈관염이다. HSP의 위장관 증상은 때로 다량의 위장관 출혈, 장천공, 장중첩 등의 위중한 형태로 나타날 수 있는데, 이 중 일부 환자는 corticosteroid 치료에도 불구하고 증상이 호전되지 않는 경우가 있다. 저자들은 심한 위장관 증세를 보이면서 스테로이드에 반응하지 않는 HSP 환아에서 IVIG 치료의 효과를 알아보고자 하였다. 방 법 : 1999년 4월부터 2005년 1월까지 심각한 위장관 증상으로 입원한 22명의 HSP 환아들의 의무기록을 조사하였다. 이들 모두에서 처음엔 methylprednisolone(2 mg/kg)을 정맥 투여하였으며, 스테로이드 치료에 반응이 없는 환아들을 대상으로 하여 IVIG(2 g/kg)을 투여하였다. 결 과 : 대량의 위장관 출혈과 복통 등이 동반된 심한 위장관 증상을 나타낸 22명의 환아(연령 : 2.3-15세, 성별 M : F=12 : 10)중에 12명이 스테로이드 치료에도 불구하고 증상이 호전되지 않아 고용량 IVIG 치료를 받았다. IVIG 투여 전, methylprednisolone 정맥주사의 평균 투여기간은 $5.6{\pm}4.9$일이었으며 12명 중 11명에서 IVIG 투여 후 1시간에서 5일 사이에 위장관 증상이 호전되었다. 나머지 1명은 IVIG 투여 후에도 복통이 있었으나, 혈변은 소실되었다. IVIG을 투여받은 환아들과 corticosteroid만을 투여받은 환아들간에 입원기간의 차이는 없었다($12.8{\pm}7.6$일 vs. $13.2{\pm}7.8$일, P=0.777). 복통이 지속되었던 총기간은 IVIG 투여군이 짧았으나 통계적으로는 유의하지 않았다($8.8{\pm}8.1$일 vs. $14.8{\pm}16.9$일, P=0.306). Methylprednisolone 정맥주사만을 단독으로 치료받은 10명 중 2명(20%)은 장천공으로 수술을 받았으나, IVIG 투여군 12명에서는 장천공이 전혀 발생하지 않았다. 결 론 : 심한 위장관 침범이 있는 HSP 환아의 복부증상이 기존의 스테로이드 치료에도 불구하고 호전되지 않을 때에는 고용량 정맥 면역글로불린 투여를 고려해 볼 수 있을 것이다.

호중구 감소된 급성 림프구성 백혈병환아에서 발생한 Pneumocystis carinii 폐렴 1례 (A Case of Pneumocystis carinii Pneumonia with Febrile Neutropenia in Acute Lymphoblastic Leukemia)

  • 최영환;민기식;김종완;김광남;유기양
    • Pediatric Infection and Vaccine
    • /
    • 제4권1호
    • /
    • pp.174-182
    • /
    • 1997
  • Pneumocystis carinii pneumonia mainly occurs in immunocompromised patients and it is also known of major cause of death in children with acute lymphoblastic leukemia. After consolidation chemotherapy, acute lymphoblastic leukemia children is developed Pneumocystis carinii pneumonia frequently no an opportunistic infection but there were no controlled studies which have been performed to evaluate the usefulness of corticosteroid in Pneumocystis carinii pneumonia with acute lymphoblastic leukemia. We experienced a case of Pneumocystis carinii pneumonia in acute lymphoblastic leukemia with febrile neutropenic 6 years old girl. She was treated with trimethoprim-sulfamethoxazole and prednisone. We report this case with brief review of related literature.

  • PDF

급성 신부전을 보인 아세트아미노펜에 의한 급성 간질성 신염 1례 (A Case of Acetaminophen-induced Acute Interstitial Nephritis Presenting with Acute Renal Failure)

  • 전학수;하태선
    • Childhood Kidney Diseases
    • /
    • 제10권2호
    • /
    • pp.228-232
    • /
    • 2006
  • Acute interstital nephritis can occur by acetaminophen, but it is rarely presented as acute renal failure with azotemia. We report a case of acute interstitial nephritis induced by acetaminophen in a 14-year-old girl who developed non-oliguric acute renal failure. She has taken acetaminophen to control the persistent throat pain for the last two months. Renal biopsy revealed diffuse infiltration of mononuclear inflammatory cells admixed with eosinophils in the edematous interstitia. After the discontinuation of acetaminophen and the administration of corticosteroid, the serum creatinine level returned to normal.

  • PDF

경막외강내 스테로이드 투여후 관찰된 혈중 Prolactin 증가와 유즙 분비 -증례 보고- (Hyperprolactinemia and Galactorrhea Following Single Epidural Steroid Injection)

  • 원석규;전용석;석민호;심재철
    • The Korean Journal of Pain
    • /
    • 제11권1호
    • /
    • pp.150-154
    • /
    • 1998
  • Epidural steroid injection have become one of the most frequently applied conservative option for the management of acute and chronic back pain. As the indications for epidural steroid injections increase so do the adverse responses associated with this procedure. This study reports the succession of 3 patients who developed galactorrhea and hyperprolactinemia after recieving an epidural steroid injection for lumbar radiculopathy and low back pain. Serum prolactin level was elevated in accordance with epidural injection of corticosteroid. We measured the serum prolactin level by immunoradiometric assay method and peak serum prolactin level at above 500, 144.2, 150.3 ng/ml respectively. Also we found the serum prolactin level decreased to normal values 3 wks after corticosteroid injection. Galactorrhra ceased in advance of decrease of serum prolactin level. That "Hyperprolactinemia and galactorrhea can occur following epidural steroid injection", requires a much larger prospective investigation.

  • PDF

Efficacy of Korean Red Ginseng in the Treatment of Alopecia Areata

  • Oh, Ga-Na;Son, Sang-Wook
    • Journal of Ginseng Research
    • /
    • 제36권4호
    • /
    • pp.391-395
    • /
    • 2012
  • Alopecia areata (AA) is an autoimmune disease that can affect any hair-bearing area. AA is known to be caused by immunological disorder but still, the pathogenesis is not fully understood. Many therapeutic modalities have been used to treat alopecia areata, with variable efficacy and safety profiles. Unfortunately, none of these agents is definitely curative or preventive alone. We studied hair growth efficacy and safety of Korean red ginseng (KRG) in AA comparing corticosteroid intra-lesional injection (ILI) alone patient group with ILI with KRG taking patient group using Folliscope 2.5 for 12 wk. Herein, we would like to report the efficacy of KRG in the treatment of AA and recommend KRG as a useful complimentary food for gaining efficacy of treatment for AA.

국소 겉질스테로이드 주사 후 발생한 지방위축증 (Two Cases of Lipoatrophy after Local Corticosteroid Injection)

  • 김인하;이혜림;이상수
    • Annals of Clinical Neurophysiology
    • /
    • 제17권2호
    • /
    • pp.91-94
    • /
    • 2015
  • The adverse effects of systemic steroid medications are well known, whereas those of local steroid injections are unclear even to clinicians. We report two cases of localized lipoatrophy and depigmentation following local steroid injection. Although the incidence of soft tissue atrophy after local steroid injection is rare, it will increase in proportion to the frequency of the procedure. All clinicians, even those who do not perform steroid injections, should be aware of the occurrence of this cosmetically disturbing adverse effect.

Acute Respiratory Distress Syndrome With Alveolar Hemorrhage due to Strongyloidiasis Hyperinfection in an Older Patient

  • Kim, Eun Jin
    • Annals of Geriatric Medicine and Research
    • /
    • 제22권4호
    • /
    • pp.200-203
    • /
    • 2018
  • Strongyloides stercoralis is an intestinal nematode that occurs sporadically in temperate areas like Korea. People who are in the immunosuppressed state, over the age of 65 or under the corticosteroid therapy are at risk for developing Strongyloides hyperinfection syndrome. Acute respiratory distress syndrome (ARDS) with alveolar hemorrhage is a rare presentation of Strongyloides hyperinfection. A 78-year-old man had been irregularly injected corticosteroid on his knees, but did not have any immunosuppressive disease. He was initially diagnosed with ARDS and septic shock. Bronchoalveolar lavage (BAL) fluid was bloody and its cytology revealed helminthic larvae identified as S. stercoralis. Results of Cytomegalovirus polymerase chain reaction (PCR), Pneumocystis jirovecii PCR, and Aspergillus antigen testing of the BAL fluid were positive. The clinical progress quickly deteriorated with multiple organ failure, shock and arrhythmia, so he finally died. This is a rare case of ARDS in an older patient without any known immunosuppressive conditions, with alveolar hemorrhage and S. stercoralis being found via BAL.

Successful Management of Eosinophilic Bronchopneumopathy in a Dog

  • Kim, Sol;Seo, Kyoungwon;Song, Kunho
    • 한국임상수의학회지
    • /
    • 제38권6호
    • /
    • pp.269-273
    • /
    • 2021
  • A dog was presented with a cough, dyspnea, nasal discharge, gagging, and exercise intolerance. The dog showed leukocytosis, peripheral eosinophilia, and an increase C-reactive protein. The radiographic findings noted bronchointerstitial infiltration, intrathoracic lymphadenopathy, and soft tissue opacity mass. Computed tomography findings showed thickening of the bronchus and bronchiole. Also, peri-bronchial consolidation and generalized intrathoracic lymphadenopathy was present. On blind bronchoalveolar lavage and pulmonary cytology, there were significantly increased eosinophils. Canine pulmonary respiratory pathogens from a real-time polymerase chain reaction analysis was negative. Consequently, the dog was diagnosed with eosinophilic bronchopneumopathy. Clinical signs improved significantly within a few days after treatment with an oral corticosteroid.