• Title/Summary/Keyword: Rare disease

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A Case of Pulmonary Thromboembolism in Crohn's Disease (크론병 환자에서 발생한 폐동맥 색전증 1예)

  • Chung, Eui-Sung;Kim, Jeong-Ho;Jung, Jin-Hwan;Shin, Ju-Young;Yeom, Ju Ok;Kang, Ji Young;Yoon, Hyoung-Kyu;Song, Jeong Sup
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.370-373
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    • 2009
  • Crohn's disease, a major form of inflammatory bowel disease (IBD), is a chronic inflammatory condition that is characterized by microvascular and macrovascular involvement. Some extraintestinal complications can occur due to chronic systemic inflammation in IBD. Among them, a pulmonary thromboembolism is a rare manifestation of IBD but is associated with a high morbidity and mortality. To our best of knowledge, there is only one case report of a pulmonary thromboembolism as a complication of Crohn's disease in Korea. We present another rare case of pulmonary thromboembolism as complication in a 25-year-old man with underlying Crohn's disease.

A case of regression of atypical dense deposit disease without C3 deposition in a child

  • Kim, Min-Sun;Hwang, Pyoung-Han;Kang, Mung-Jae;Lee, Dae-Yeol
    • Clinical and Experimental Pediatrics
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    • v.53 no.7
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    • pp.766-769
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    • 2010
  • Dense deposit disease (DDD) is a rare disorder characterized by the deposition of abnormal electron-dense material within the glomerular basement membrane of the kidneys. The diagnosis is made in most patients between 5 and 15 years of age, and within 10 years, approximately half of the affected patients progress to end-stage renal disease. We report a rare case of regressive DDD without C3 deposition after steroid therapy in an 11-year-old boy. The patient presented with edema, gross hematuria, and nephrotic-range proteinuria. Laboratory testing revealed a serum creatinine level of 1.17 mg/dL, albumin level of 2.3 g/dL, and serum C3 level of 125 mg/dL (range 90-180 mg/dL). The results of the renal biopsy were consistent with DDD without C3 deposition. After 6 weeks of steroid therapy, the nephrotic syndrome completely resolved. The follow-up renal biopsy showed a significant reduction in mesangial proliferation and disappearance of electron-dense deposits in the GBM.

Pseudohypoaldosteronism Type 1

  • Cheong, Hae Il
    • Journal of Genetic Medicine
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    • v.10 no.2
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    • pp.81-87
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    • 2013
  • Pseudohypoaldosteronism (PHA), a rare syndrome of systemic or renal mineralocorticoid resistance, is clinically characterized by hyperkalemia, metabolic acidosis, and elevated plasma aldosterone levels with either renal salt wasting or hypertension. PHA is a heterogeneous disorder both clinically and genetically and can be divided into three subgroups; PHA type 1 (PHA1), type 2 (PHA2) and type 3 (PHA3). PHA1 and PHA2 are genetic disorders, and PHA3 is a secondary disease of transient mineralocorticoid resistance mostly associated with urinary tract infections and obstructive uropathies. PHA1 includes two different forms with different severity of the disease and phenotype: a systemic type of disease with autosomal recessive inheritance (caused by mutations of the amiloride-sensitive epithelial sodium channel, ENaC) and a renal form with autosomal dominant inheritance (caused by mutations of the mineralocorticoid receptor, MR). In the kidneys, the distal nephron takes charge of the fine regulation of water absorption and ion handling under the control of aldosterone. Two major intracellular actors necessary for the action of aldosterone are the MR and the ENaC. Impairment of the intracellular aldosterone signal transduction pathway results in resistance to the action of mineralocorticoids, which leads to PHA. Herein, ion handling the distal nephron and the clinico-genetic findings of PHA are reviewed with special emphasis on PHA type 1.

Diagnosis of Inherited Metabolic Disorders Based on Their Diverse Clinical Features and laboratory Tests (유전성 대사질환의 임상증상과 진단)

  • Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.13 no.1
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    • pp.1-19
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    • 2013
  • Inherited metabolic disorders are individually rare but as a whole, they are nor rare. Since Archibald Garrod introduced a concept of "inborn error of metabolism" or "chemical individuality", more than 600 diseases are currently known, affecting approximately one in 500 newborns cumulatively. They frequently manifest with acute, life-threatening crisis that requires immediate specific intervention or they present with insidious diverse symptoms and signs involving multiple visceral organs or tissues as well as central nervous system, hampering a correct diagnosis. In addition, many pediatricians are not familiar with all diagnostic and therapeutic strategies for diverse inherited metabolic disorders. However, the prognosis of affected children are heavily dependent on rapid and effective treatment. In this lecture, practical guidelines for the specific diagnosis based on diverse clinical features of inherited metabolic disorders will be described. Many sophisticated laboratory tests are available for the confirmatory diagnosis of each disease, which is challenging to general pediatricians with respect to knowledge about biochemical metabolite assay test, enzymatic test and DNA diagnostic tests. Sample collections, indications, methods and interpretation of results in varying laboratory tests will be listed as well.

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A Case of Granulomatosis with Polyangiitis with IgG4-Related Disease Expressed by Facial Paralysis and Hearing Loss (안면 마비와 난청으로 진단된 면역글로불린 G4 연관질환 동반 육아종성 다발 혈관염 1예)

  • Kim, Hyung-sik;Doo, Jeon Gang;Yeo, Seung Geun;Kim, Sang Hoon
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.240-244
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    • 2018
  • Granulomatosis with polyangiitis (GPA) and Immunoglobulin (Ig) $G_4$-related disease ($IgG_4$-RD) are rare diseases and early diagnosis and proper management are imperative to prevent multi-organ damage. The authors present a case of a 60 years old woman who had facial paralysis and hearing loss. Lt intact canal wall tympanomastoidectomy, Lt facial nerve decompression and ossiculoplasty with partial ossicular replacement prosthesis (PORP) was done. During operation, middle ear tissue was biopsied and GPA with $IgG_4$-RD was diagnosed. After methyl prednisolone (MPD) pulse therapy and azathioprine therapy, the severity of paralysis was improved. We present this case because common otologic symptoms like facial palsy and hearing loss could be initial symptoms of rare systemic disease.

Actinomycotic Osteomyelitis of the Mandible: A Case Report

  • Lee, Young-Cheol;Lim, Lee-Rang;Lee, Kyu-Hoon;Seo, Dong-Jun;Yun, Na-Ra;Oh, Ji-Su;You, Jae-Seek;Choi, Hae-In
    • Journal of Oral Medicine and Pain
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    • v.44 no.3
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    • pp.140-144
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    • 2019
  • Actinomycosis is rare, chronic, slowly progressive disease caused by gram-positive anaerobic organisms from the Actinomycosis family that normally colonizes the oral cavity. Actinomycotic osteomyelitis is even more rare and refractory disease because diagnosis by bacterial culture is not easy. In our case, 80-year-old man visited our clinic with a complaint of swelling and severe sinus tracts without teeth evolvement on anterior mandible. Computed tomography (CT) scan demonstrated erosive bone destruction on anterior mandible, clinically suspected actinomycotic osteomyelitis. The patient also had thoracic actinomycosis on Lt. lower lung. We could diagnosis actinomycosis by histopathologic examination. He treated by conservative surgery and long term antibiotics. After 2 year, no recurrence was seen in CT scan.

Congenital Quadricuspid Aortic Valve Disease (선천성 사엽성 대동맥 판막 질환)

  • Park Chan Beom;Kim Jae Jun;Jo Min Seop;Jin Ung;Cho Deog-Gon;Park Kuhn;Cho Kyu-Do;Kim Chi Kyung
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.780-782
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    • 2005
  • The quadricuspid aortic valve is a rare congenital cardiac morphology. In regard to the hemodynamics of the quadricuspid aortic valve, the regurgitation is most common, the regurgitation accompanying the stenosis or pure stenosis are rare. We report hear a case with quadricuspid aortic valve disease which has been known to be extremely rare.

Extraskeletal Ewing Sarcomas in Late Adolescence and Adults: A Study of 37 Patients

  • Tao, Hai-Tao;Hu, Yi;Wang, Jin-Liang;Cheng, Yao;Zhang, Xin;Wang, Huan;Zhang, Su-Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2967-2971
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    • 2013
  • Background: Extraskeletal Ewing sarcoma (EES)/primitive neuroectodermal tumours (PNET) are rare soft tissue sarcomas. Prognostic factors and optimal therapy are still unconfirmed. Materials and Methods: We performed a retrospective analysis on patients to explore the clinic characteristics and prognostic factors of this rare disease. A total of 37 patients older than 15 years referred to our institute from Jan., 2002 to Jan., 2012 were reviewed. The characteristics, treatment and outcome were collected and analyzed. Results: The median age was 28 years (range 15-65); the median size of primary tumours was 8.2 cm (range 2-19). Sixteen patients (43%) had metastatic disease at the initial presentation. Wide surgical margins were achieved in 14 cases (38%). Anthracycline or platinum-based chemotherapy was performed on 29 patients (74%). Radiotherapy was delivered in 13 (35%). At a median follow-up visit of 24 months (range 2-81), the media event-free survival (EFS) and overall survival (OS) were 15.8 and 30.2 months, respectively. The 3-year EFS and OS rates were 24% and 43%, respectively. Metastases at presentation and wide surgical margins were significantly associated with OS and EFS. Tumour size was significantly associated with OS but not EFS. There were no significant differences between anthracycline and platinum based chemotherapy regarding EFS and OS. Conclusions: EES/PNET is a malignant tumour with high recurrence and frequent distant metastasis. Multimodality therapy featuring wide surgical margins, aggressive chemotherapy and adjuvant local radiotherapy is necessary for this rare disease. Platinum-based chemotherapy can be used as an adjuvant therapy.

Joint Problems in Patients with Mucopolysaccharidosis Type II

  • Kim, Min-Sun;Kim, Jiyeon;Noh, Eu Seon;Kim, Chiwoo;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.5 no.1
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    • pp.17-21
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    • 2021
  • Hunter syndrome or mucopolysaccharidosis type II (MPS-II) (OMIM 309900) is a rare lysosomal storage disorder caused by deficiency in the activity of the enzyme iduronate-2-sulfatase. This enzyme is responsible for the catabolism of the following two different glycosaminoglycans (GAGs): dermatan sulfate and heparan sulfate. The lysosomal accumulation of these GAG molecules results in cell, tissue, and organ dysfunction. Patients can be broadly classified as having one of the following two forms of MPS II: a severe form and an attenuated form. In the severe form of the disease, signs and symptoms (including neurological impairment) develop in early childhood, whereas in the attenuated form, signs and symptoms develop in adolescence or early adulthood, and patients do not experience significant cognitive impairment. The involvement of the skeletal-muscle system is because of essential accumulated GAGs in joints and connective tissue. MPS II has many clinical features and includes two recognized clinical entities (mild and severe) that represent two ends of a wide spectrum of clinical severities. However, enzyme replacement therapy is likely to have only a limited impact on bone and joint disease based on the results of MPS II studies. The aim of this study was to review the involvement of joints in MPS II.

Behcet's Disease with the Left Carotid Artery Aneurysm and Colon Perforation (좌측 경동맥류와 대장천공을 동반한 베체트병)

  • 전준경;장원채;최용선;오봉석
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.279-281
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    • 2004
  • Behest's disease is manifested as ulcers present in oral cavity, on external genital organ, orbital area, and skin. This disease could also cause other symptoms by invading the cardiovascular system, respiratory system, gastrointestinal system, central nervous system, and urogenital system. It is very rare for Behcet's disease to be accompanied by carotid artery aneurysm and intestinal perforation. We report a patient with Behcet's disease, who is diagnosed with symptoms and pathological findings as haying carotid artery aneurysm and intestinal perforation at the same time. The patient underwent operation for the aneurysm and the intestinal perforation.