• Title/Summary/Keyword: generalized edema

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Acute tubular necrosis as a part of vancomycin induced drug rash with eosinophilia and syste­mic symptoms syndrome with coincident post­infectious glomerulonephritis

  • Kim, Kyung Min;Sung, Kyoung;Yang, Hea Koung;Kim, Seong Heon;Kim, Hye Young;Ban, Gil Ho;Park, Su Eun;Lee, Hyoung Doo;Kim, Su Young
    • Clinical and Experimental Pediatrics
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    • v.59 no.3
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    • pp.145-148
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    • 2016
  • Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal condition characterized by skin rash, fever, eosinophilia, and multiorgan involvement. Various drugs may be associated with this syndrome including carbamazepine, allopurinol, and sulfasalazine. Renal involvement in DRESS syndrome most commonly presents as acute kidney injury due to interstitial nephritis. An 11-year-old boy was referred to the Children's Hospital of Pusan National University because of persistent fever, rash, abdominal distension, generalized edema, lymphadenopathy, and eosinophilia. He previously received vancomycin and ceftriaxone for 10 days at another hospital. He developed acute kidney injury with nephrotic range proteinuria and hypocomplementemia. A subsequent renal biopsy indicated the presence of acute tubular necrosis (ATN) and late exudative phase of postinfectious glomerulonephritis (PIGN). Systemic symptoms and renal function improved with corticosteroid therapy after the discontinuation of vancomycin. Here, we describe a biopsy-proven case of severe ATN that manifested as a part of vancomycin-induced DRESS syndrome with coincident PIGN. It is important for clinicians to be aware of this syndrome due to its severity and potentially fatal nature.

An Aortic Dissection in Pregnant Woman -a case report- (임산부에서 발생한 대동맥 박리 (Aortic Dissection) 1례)

  • Lee, Hyeong-Min;Hong, Eun-Pyo;Lee, Dong-Hyup;Lee, Jung-Cheul;Han, Sung-Sae;Sin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Sup
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.253-259
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    • 1993
  • We have experienced a case of aortic dissecting aneurysm in pregnant woman. She felt initially severe chest pain which was radiated to the neck on the 3days before delivery. Thereafter dyspnea and generalized edema were developed for 1 month after delivery. She was diagnosed as aortic dissection, Debakey typeII. During cardiopulmonary bypass, the selective cerebral perfusion was done through the right and left commom carotid arteries. Aortic replacement with Hemashield vascular graft and reimplantation of innominate artery, resuspension of aortic valve, repair of intimal tear were performed. The postoperative course was uneventful.

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Adverse Drug Reactions of Dextran 40 Treated to the Cerebral Infarction Patients (뇌경색 환자에게 사용된 덱스트란 40의 부작용 분석)

  • Kim, Jae-Hyeon
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.473-481
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    • 2016
  • Adverse drug reactions(ADRs) were caused by dexran 40 in patient with ischemic stroke and related 22 patients reported to formal ADRs at Jesus Hospital in Jeonju. This study was aimed to search ADRs related factors, type and the degree associated with dextran 40. Adverse Effects of Dextran 40 is including marked hypotension, nausea, dyspnea, generalized urticaria, fever and pulmonary edema. The average hospitalization period was 20 days and it was extended 26.8%. ADRs of Dextran 40 to incidence is 12.4%, and 9 persons(28.1%), itching, rash was 7 people (21.9%). Dextran induced ADRs reaction may be reported on early injection period and first time shot, but adverse drug reactions occurred after 4 days in 4 patients(18.2%). US FDA has recommanded that Dextran 1 significantly reduces the incidence of severe ADRs in USA. Because low molecular weighted dextran 1 prevented dextran molecules from combined Ig G completely. In Korea. Generally not yet introduced dextran 1, active use dextran 1 is able to be a good way in order to reduce ADRs of dextran 40.

미숙아와 신생아의 동맥과 개존증에 대한 수술요법(소개흉 결찰술과 흉강경 보조하의 clipping과의 비교)

  • 장지원;한재진;원용순;원태희;안재호;박영식;최수승
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.26-31
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    • 2000
  • Background: This study was aimed at analyzing the preoperative conditions post-operative results indication and methods of surgical closure of patent ducturs arterio년 in prematures low birth weight infants and neonates. Patients and Methods: We retro-spectively studied two groups of patients (prematures group and neonates group) who underwent surgical closure of the patent ductus arteriosus between March 1995 and June 1998. Results: The premature group consisted of 9 patients(3 males and 6 females) Their mean gestational period was 30.7 weeks(ranging from 26 weeks to 33 weeks) mean age 27.8 days(11 days to 55 days) and mean body weight 1.56 kg. Prominent preoperative symptoms were dependency on mechanical ventilation generalized edema and hepatomegaly. We performed PDA ligation via thoracotomy in all premature patients. The neonate group consisted of 16 patients and their mean body weight was 3.75 kg. Major symptoms of this group was tachypnea and intercostal retraction resistant to medical treatment. We performed video-assisted PDA clipping to them all. There were no postoperative complications or operation-related mortality in both groups. Comparing the ratio of size of PDA(mm)/body weight(kg) the ratio of premature group (ligation through thoracotomy) was higher than that of neonate group ( video-assisted clipping) that is 3,89:1.21(p=0.03) Conclusion : We conclude that the surgical closure of PDA can be a safe method of treatment for prematures low birth weight infants and neonates with compromised general conditions. Choice of surgical technique depends on the surgeon's preference but there was a tend-ency to choose the ligation method through thoracotomy for patients with small body weight and large PDA.

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A Case of Sleep Apnea Syndrome due to Primary Hypothyroidism (갑상선 기능 저하증에 의한 수면 무호흡 증후군 1예)

  • Wie, Seong-Heon;Kim, Sang-Woo;Choi, Young-Mi;Lee, Suk-Young;Moon, Hwa-Sik;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.238-243
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    • 1995
  • Sleep Apnea Syndrome is characterized by hypersomnolence, snoring, and sleep apnea. The symptoms of hypothyroidism include apathy, somnolence, lethargy, personality change, and intellectual deterioration and may be related to hypothyroid-related sleep disorders. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A 60-yr-old man was admitted due to hypersomnolence, snoring and generalized edema. Polysomnogram showed obstructive pattern of sleep apnea syndrome. Neck CT scan revealed narrowing of upper airway which is consistent with obstructive sleep apnea syndrome. Physical examination and hormonal study also disclosed the evidence of hypothyroidism. We report a case of sleep apnea syndrome due to primary hypothyroidism with review of literatures.

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Cytomegalovirus-induced Childhood Menetrier's Disease with Peripheral Eosinophilia (호산구 증가증을 동반한 거대세포바이러스 감염 소아 Menetrier병 1례)

  • Choi, Won Joung;Lee, Bo Young;Lee, Hee Jung;Oh, Hoon Kyu;Hwang, Jin Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.87-91
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    • 2004
  • Herein, the case of a 5-year-old boy with cytomegalovirus-induced Menetrier's disease, with peripheral eosinophilia, presenting with abdominal pain and vomiting, followed by generalized edema, is reported. The initial laboratory findings, hypoalbuminemia and peripheral eosinophilia were noted, with no evidence of renal, hepatic, cardiac or allergic diseases. Gastrofiberscopy was performed under the suspicion of eosinophilic gastroenteritis with protein losing gastropathy. The gastrofiberscopy showed the characteristic features of giant hypertrophy of the gastric rugae, with large quantities of adherent gelatinous material on the gastric fundus and body. The histological findings revealed foveolar hyperplasia, compatible with Menetrier's disease, with massive eosinophilic infiltrations. The presence of cytomegalovirus infection was identified by serology and confirmed by urine PCR. His symptoms, gastrofiberscopic findings and peripheral eosinophilia resolved spontaneously, and he has remained well for 10 months.

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Study on the Development of Diagnosis Algorithm of Soeumin Symptomology (소음인(少陰人) 병증(病證) 진단 알고리즘 개발 연구)

  • Shin, Seung-Won;Lee, Eui-Ju;Koh, Byung-Hee;Lee, Jun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.1
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    • pp.33-43
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    • 2011
  • 1. Objectives: This study is aimed to develop the algorithm, which can help clinicians diagnose Soeumin's symptomology, based on the indexes such as dry mouth, water drinking, sweat, urine, appetite, digestion, and stool, etc. 2. Methods: This research analyzes the items of "Donguisusebowon(東醫壽世保元)" to reveal the inevitable and sequential indexes of Soeumin's symptomology diagnosis, in order of exterior-interior pattern differentiation, favorable-unfavorable pattern differentiation, and mild-severe-dangerous-urgent pattern differentiation. 3. Results and Conclusions: 1) 1st step: Soeumin's exterior pattern and interior pattern are differentiated in terms of heat and cold, respectively. Stool and digestion are used to confirm the difference. 2) 2nd step: The existence of sweat is used to find out that an exterior pattern is with or without favor, while the indexes of stool, dry mouth, and generalized pain are used to identify an interior pattern with or without favor. 3) 3rd step: The favorably exterior-heat pattern can be either mild or severe by the indexes of cold-heat, stool, tidal fever, and manic raving, panting and straight looking, while the unfavorably exterior-heat pattern can be either dangerous or urgent by the ones of cold-heat, stool, and urine. And, the favorably interior-cold pattern can be either mild or severe by the indexes of stuffiness and fullness, jaundice, and edema, while the unfavorably interior-cold pattern can be either mild or severe by the ones of vexation level.

Repair of Posttraumatic Tricuspid Regurgitation Using Artificial Chordae and an Annuloplasty Ring (인공 건삭과 판막륜 성형술을 이용한 외상 후 삼첨판 부전증의 치료)

  • Son, Kuk-Hui;Son, Ho-Sung;Chung, Jae-Ho;Chung, Won-Jae;Sun, Kyung;Lee, Sung-Ho
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.489-491
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    • 2008
  • A 52-year-old man was taken to the emergency room following a motor vehicle accident. An echocardiogram showed moderate to severe tricuspid regurgitation due to rupture of the anterior chordae. An operation to repair the tarumatic tricuspid regurgitation was recommended; however, the patient refused because he was asymptomatic. Two years later, he developed mild generalized edema and dyspnea. The echocardiogram revealed progressive severe tricuspid regurgitation and annular dilatation. We treated the tricuspid regurgitation successfully using artificial chordae and ring annuloplasty.

POEMS syndrome misdiagnosed as bone metastasis in a patient with thyroid cancer (갑상선암 환자에서 골전이로 오인된 POEMS 증후군)

  • Baek, Sang Ah;Ryoo, Hun Mo;Bae, Sung Hwa;Cho, Yoon Young;Kim, Seong gyu;Kim, Ga Young;Kim, Min Keun
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.122-126
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    • 2015
  • Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.

A Case Report of Thymic Carcinoid Tumor Associated with Cushing's Syndrome: Possible Corticotropin-Releasing Hormone Secreting Tumor (쿠싱 증후군 일으킨 카르시노이드종양의 1예 보고: 코르티코트로핀분비호르몬 분비하는 종양 의증)

  • Chon Soon-Ho;Ro Sun-Kyun;Oh Young-Ha;Kang Jun-Goo;Yeom Jong-Hoon;Lee Chul-Burm
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.795-798
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    • 2006
  • Thymic carcinoid tumor associated with Cushing's syndrome is a rare disease with a poor prognosis. Thymic carcinoid with Cushing's syndrome caused by CRH (corticotropin-releasing hormone) production is even rarer. We report a 58-year-old woman with a huge anterior mediastinal mass. Five months after thymectomy the patient was readmitted with symptoms of generalized edema and dyspnea. Recurrence and metastases were discovered and Cushing's syndrome diagnosed.