• Clinical and Experimental Pediatrics
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• 제54권4호
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• pp.176-178
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• 2011

Hemolytic-uremic syndrome (HUS) is the most common cause of acute renal failure in young children. It is classically characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and uremia. Further, not only is intussusception one of the differential diagnoses of HUS but it may also become a complication during disease progression. We report a case of HUS. preceded by intussusception in a previously healthy 17-month-old boy. The patient presented at the emergency department with bloody stools that developed the day after reduction of intussusception. HUS was diagnosed 4 days after the reduction of intussusception. The patient was provided only supportive care and his laboratory test findings were normal at discharge.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.207-211
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• 2012

Hemolytic uremic syndrome (HUS) is a rare disorder characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. HUS arises from a wide spectrum of conditions, and chemotherapeutic agents have been reported to be associated with HUS, including Mitomycin, Cisplatin, Bleomycin, and Gemcitabine. A 76-year-old man treated with Gemcitabine due to non-small cell lung cancer developed clinical and laboratory findings compatible with HUS. Gemcitabine was ceased and hemodialysis and plasma exchange were utilized and he recovered. A high level of suspicion for HUS is necessary when cancer patients are treated with Gemcitabine, and prompt recognition and treatment are also essential.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.299-304
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• 2021

Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

• Childhood Kidney Diseases
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• 제7권1호
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• pp.82-85
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• 2003

저자들은 18개월된 남자 환아에서 아메바성 장염 후 급성 신부전, 미세혈관성 용혈성 빈혈, 혈소판 감소증의 전형적 용혈성 요독 증후군이 발생한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제59권2호
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• pp.100-103
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• 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.

• Imaging Science in Dentistry
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• 제52권2호
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• pp.133-140
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• 2022

Purpose: The aim of this review was to systematically analyze the available literature on the correlation between the gray values (GVs) of cone-beam computed tomography (CBCT) and the Hounsfield units (HUs) of computed tomography (CT) for assessing bone mineral density. Materials and Methods: A literature search was carried out in PubMed, Cochrane Library, Google Scholar, Scopus, and LILACS for studies published through September 2021. In vitro, in vivo, and animal studies that analyzed the correlations GVs of CBCT and HUs of CT were included in this review. The review was prepared according to the PRISMA checklist for systematic reviews, and the risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A quantitative analysis was performed using a fixed-effects model. Results: The literature search identified a total of 5,955 studies, of which 14 studies were included for the qualitative analysis and 2 studies for the quantitative analysis. A positive correlation was observed between the GVs of CBCT and HUs of CT. Out of the 14 studies, 100% had low risks of bias for the domains of patient selection, index test, and reference standards, while 95% of studies had a low risk of bias for the domain of flow and timing. The fixed-effects meta-analysis performed for Pearson correlation coefficients between CBCT and CT showed a moderate positive correlation (r=0.669; 95% CI, 0.388 to 0.836; P<0.05). Conclusion: The available evidence showed a positive correlation between the GVs of CBCT and HUs of CT.

• Clinical and Experimental Pediatrics
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• 제53권2호
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• pp.253-257
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• 2010

용혈성 요독 증후군은 미세혈관병성 용혈성 빈혈, 급성 신부전 및 혈소판감소증을 특징으로 하며 4세 미만 소아의 급성 신부전의 가장 흔한 원인이 된다. 설사 연관형 용혈성 요독 증후군은 설사가 전구 증상으로 동반되며, shiga-toxin을 생산하는 Escherichia coli O157:H7 또는 Shigella dysenteriae 감염이 원인으로써 비교적 예후가 좋다. 하지만, 비전형적인 경우는 재발할 수 있으며 더 불량한 예후를 보인다. 소아에서는 용혈성 요독 증후군이 선행된 급성 림프모구성 백혈병은 매우 드물게 보고되며, 이들에서의 임상적인 특징이나 기저 기전은 잘 알려져 있지 않다. 이에 저자들은 11세 남아에서 비전형적 용혈성 요독 증후군 후에 발생한 급성 림프모구성 백혈병 1예를 보고하는 바이며, 이와 같은 비전형적인 경우에는 급성 림프모구성 백혈병의 가능성을 염두해 두어야 할 것으로 사료된다.

• 한국지반공학회지:지반
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• 제32권6호
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• pp.19-26
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• 2016

• 대한약학회:학술대회논문집
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• 대한약학회 2000년도 NEW STRATEGY FOR DRUG DEVELOPMENT IN POST-GENOMIC ERA(대한약학회)
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• pp.93-94
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• 2000

• Clinical and Experimental Pediatrics
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• 제50권12호
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• pp.1261-1265
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• 2007

근래 용혈요독증후군의 신외 증상에 대한 인식이 점점 더 증가하고 있으며 이환률과 사망률의 주요 결정인자가 되고 있다. 용혈요독증후군 환자의 심장동맥순환계에서 미소혈전이 발견되는 일은 흔하지만 실제 임상적으로 명백하게 발현하는 폐 혹은 심장 합병증은 흔하지 않다. 저자들은 용혈요독증후군으로 치료 받던 10개월 영아에서 폐출혈, 급성호흡곤란증후군, 확장심근병증 등이 발생하여 지지요법 후 회복된 1례를 경험하여 문헌고찰과 함께 보고하는 바이다.