• Title/Summary/Keyword: self-limiting disease

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Diagnosis and Management of Ménétrier Disease in Children: A Case Series Review

  • Krikilion, Jasmina;Levy, Elvira Ingrid;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.109-117
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    • 2021
  • Purpose: Ménétrier disease (MD) was first described in 1888, and 50 cases have been reported until now. We aimed to discuss the etiology, diagnostics, and management of MD in children. Methods: We searched for case reports published from 2014 till 2019 in English using PubMed. Articles were selected using subject headings and key words of interest to the topic. Interesting references of the included articles were also included. Results: The pathophysiology of MD is still uncertain. However, overexpression of transforming growth factor alpha with transformation of the gastric mucosa has been observed, which may be mediated by genetics and provoked by an infectious trigger. Clinically, MD is diagnosed by abdominal pain, vomiting, anorexia, and edema secondary to hypoalbuminemia. A gastroscopy with biopsy is the gold standard for the diagnosis of MD. In children, the disease is self-limiting and only requires supportive treatment. In general, children have a good prognosis and recover spontaneously within a few weeks. Conclusion: Few pediatric cases of MD have been described in recent years, and with all different etiology. Endoscopy with biopsy remains the golden standard for the diagnosis of MD, and in children, the disease is self-limiting.

Clinical Characteristics of Subacute Necrotizing Lymphadenitis in Pediatrics (소아에서의 아급성 괴사성 림프절염의 임상적 고찰)

  • Kim, Hee-Kyu
    • Korean Journal of Bronchoesophagology
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    • v.6 no.1
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    • pp.21-28
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    • 2000
  • Background:Subacute necrotizing lymphadenitis or Kikuchi's disease is unknown ethiology and self-limiting process. This disease predominantly affects young women age but rarely affects pediatrics, and usually manifests as lymphadenopathy and fever. Even though this disease is self-limited, benign process, many cases are misidentified as malignant lymphoma. The purpose of this study is to report the clinicopathologic finding, radiological finding and many labolatory test and to compare with characteristics of adult patients in this disease. Meterial and Methods:We reviewed 27 pediarics patients with subacute necrotizing lymphadenitis by excision biopsy or fineneedle aspiration cytology.Result:The most common symptomes were palpation of cervical lymh node(88.9%) and fever(66.7%). The common site of the involvement was cervical lymph node. The multiple involvement was 93% and bilateral involvement was 59%. Leukopenia(52%) and elevated erythrocyte sedimentation rates(93%) appeared in abnormal laboratory data. Microscopically, the characteristic finding was the wide area of florid nuclear dusts engulfed by histiocytes and well-circumscrbed area with eosinophilic fibrinoid material. There was a striking degree ofkaryorrhexis and an absence of granulocyte with paucity of plasma cell. All patients recovered with the conservative treatment and there was no specific complication and recurrence. Conclusion : We reviewed pediatric patients with this disease. Characteristics of this disease inpediatric patients were similar to adult patients.

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A case of Kikuchi-Fujimoto disease with autoimmune thyroiditis

  • Go, Eun Ji;Jung, You Jin;Han, Seung Beom;Suh, Byung Kyu;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.55 no.11
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    • pp.445-448
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    • 2012
  • Kikuchi-Fujimoto disease (KFD) is a benign self-limiting disease characterized by fever and lymphadenitis. The etiology and pathogenesis of KFD is unclear. However, two hypotheses have been suggested: a viral infection hypothesis and an autoimmune hypothesis. Several KFD patients with various types of autoimmune diseases have been reported, and these reports support the hypothesis for autoimmune pathogenesis of KFD. Here, we report the case of a 17-year-old female patient diagnosed with KFD and autoimmune thyroiditis. This case serves as additional evidence that the etiology of KFD is autoimmune origin.

Panosteitis in a German Shepherd Dog (셰퍼드견에서 범골염 진단례)

  • 성윤상;엄기동;이해운;이정민;장광호;오태호
    • Journal of Veterinary Clinics
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    • v.20 no.2
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    • pp.252-254
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    • 2003
  • A 18-month-old, 35.3 kg, intact male Cerman shepherd dog with a history of non-weight bearing lameness in the right hindlimb was referred to Veterinary Teaching Hospital, College of Veterinary Medicine, Kyungpook National University. On physical examination, pain response was elicited. Laboratory abnormalities were not present. Radiographic examination revealed areas of increased opacity in the medullary cavity and accentuation of trabecular patterns of the affected bone. This dog was treated with analgesics and lameness was resolved without pain.

A Case of Epiploic Appendagitis with Acute Gastroenteritis

  • Cho, Min Sun;Hwang-Bo, Seok;Choi, Ui Yoon;Kim, Hwan Soo;Hahn, Seung Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.4
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    • pp.263-265
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    • 2014
  • Epiploic appendagitis is an inflammation of the epiploic appendage in which the small sacs projecting from the serosal layer of the colon are positioned longitudinally from the caecum to the rectosigmoid area. Epiploic appendagitis is rare and self-limiting; however, it can cause sudden abdominal pain in children. Epiploic appendagitis does not typically accompany other gastrointestinal diseases. Here, we report on a healthy eight-year-old girl who presented with abdominal pain, fever, vomiting, and diarrhea. Based on these symptoms, she was diagnosed with acute gastroenteritis, but epiploic appendagitis in the ascending colon was revealed in contrast computed tomography (CT). The patient was treated successfully with conservative management. CT is beneficial in diagnosis and further assessment of epiploic appendagitis. Pediatricians need to be aware of this self-limiting disease and consider it as a possible alternate diagnosis in cases of acute abdominal pain.

Application and Expansion of the Harm Principle to the Restrictions of Liberty in the COVID-19 Public Health Crisis: Focusing on the Revised Bill of the March 2020 「Infectious Disease Control and Prevention Act」 (코로나19 공중보건 위기 상황에서의 자유권 제한에 대한 '해악의 원리'의 적용과 확장 - 2020년 3월 개정 「감염병의 예방 및 관리에 관한 법률」을 중심으로 -)

  • You, Kihoon;Kim, Dokyun;Kim, Ock-Joo
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.105-162
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    • 2020
  • In the pandemic of infectious disease, restrictions of individual liberty have been justified in the name of public health and public interest. In March 2020, the National Assembly of the Republic of Korea passed the revised bill of the 「Infectious Disease Control and Prevention Act.」 The revised bill newly established the legal basis for forced testing and disclosure of the information of confirmed cases, and also raised the penalties for violation of self-isolation and treatment refusal. This paper examines whether and how these individual liberty limiting clauses be justified, and if so on what ethical and philosophical grounds. The authors propose the theories of the philosophy of law related to the justifiability of liberty-limiting measures by the state and conceptualized the dual-aspect of applying the liberty-limiting principle to the infected patient. In COVID-19 pandemic crisis, the infected person became the 'Patient as Victim and Vector (PVV)' that posits itself on the overlapping area of 'harm to self' and 'harm to others.' In order to apply the liberty-limiting principle proposed by Joel Feinberg to a pandemic with uncertainties, it is necessary to extend the harm principle from 'harm' to 'risk'. Under the crisis with many uncertainties like COVID-19 pandemic, this shift from 'harm' to 'risk' justifies the state's preemptive limitation on individual liberty based on the precautionary principle. This, at the same time, raises concerns of overcriminalization, i.e., too much limitation of individual liberty without sufficient grounds. In this article, we aim to propose principles regarding how to balance between the precautionary principle for preemptive restrictions of liberty and the concerns of overcriminalization. Public health crisis such as the COVID-19 pandemic requires a population approach where the 'population' rather than an 'individual' works as a unit of analysis. We propose the second expansion of the harm principle to be applied to 'population' in order to deal with the public interest and public health. The new concept 'risk to population,' derived from the two arguments stated above, should be introduced to explain the public health crisis like COVID-19 pandemic. We theorize 'the extended harm principle' to include the 'risk to population' as a third liberty-limiting principle following 'harm to others' and 'harm to self.' Lastly, we examine whether the restriction of liberty of the revised 「Infectious Disease Control and Prevention Act」 can be justified under the extended harm principle. First, we conclude that forced isolation of the infected patient could be justified in a pandemic situation by satisfying the 'risk to the population.' Secondly, the forced examination of COVID-19 does not violate the extended harm principle either, based on the high infectivity of asymptomatic infected people to others. Thirdly, however, the provision of forced treatment can not be justified, not only under the traditional harm principle but also under the extended harm principle. Therefore it is necessary to include additional clauses in the provision in order to justify the punishment of treatment refusal even in a pandemic.

Intra-abdominal Kikuchi's Disease Mimicking Malignant Lymphoma on FDG PET-CT (FDG PET-CT에서 악성림프종처럼 보이는 복부 기쿠치병)

  • Han, Hye-Suk;Kim, Gi-Hyun;Cho, Young-Shim;Joo, Hye-Jin;Lee, Ok-Jun;Ryu, Dong-Hee;Lee, Ki-Hyeong;Kim, Seung-Taik
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.363-365
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    • 2009
  • Kikuchi's disease is a self-limiting benign disease characterized by cervical lymphadenopathy, but it can be mistaken for malignant disease, and when involved lymph nodes are unusually located, diagnosis can be more difficult. The authors report the case of a 19-year-old man with Kikuchi's disease, who had isolated intra-abdominal lymphadenopathy and increased 18-fluoro-deoxyglucose (FDG) uptake in positron emission tomography-computed tomography (PET-CT). Although its incidence is extremely rare, intra-abdominal Kikuchi's disease with increased FDG uptake in PET-CT image should be considered in the differential diagnosis when constitutional symptoms mimic those of malignant lymphoma.

Hemophagocytic lymphohistiocytosis with recurrent Kikuchi-Fujimoto disease

  • Lee, Sang Min;Lim, Young Tae;Jang, Kyung Mi;Gu, Mi Jin;Lee, Jong Ho;Lee, Jae Min
    • Journal of Yeungnam Medical Science
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    • v.38 no.3
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    • pp.245-250
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    • 2021
  • Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a self-limiting lymphadenitis. It is a benign disease mainly characterized by high fever, lymph node swelling, and leukopenia. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease with clinical symptoms similar to those of KFD, but it requires a significantly more aggressive treatment. A 19-year-old Korean male patient was hospitalized for fever and cervical lymphadenopathy. Variable-sized lymph node enlargements with slightly necrotic lesions were detected on computed tomography. Biopsy specimen from a cervical lymph node showed necrotizing lymphadenitis with HLH. Bone marrow aspiration showed hemophagocytic histiocytosis. The clinical symptoms and the results of the laboratory test and bone marrow aspiration met the diagnostic criteria for HLH. The patient was diagnosed with macrophage activation syndrome-HLH, a secondary HLH associated with KFD. He was treated with dexamethasone (10 mg/m2/day) without immunosuppressive therapy or etoposide-based chemotherapy. The fever disappeared within a day, and other symptoms such as lymphadenopathy, ascites, and pleural effusion improved. Dexamethasone was reduced from day 2 of hospitalization and was tapered over 8 weeks. The patient was discharged on day 6 with continuation of dexamethasone. The patient had no recurrence at the 18-month follow-up.

Study on the Identification Methods of the Non-agglutinating Vibrio (NAG Vibrio의 검사에 관한 소고)

  • Lee M. W.
    • Journal of environmental and Sanitary engineering
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    • v.2 no.2 s.2
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    • pp.61-67
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    • 1987
  • The genus Vibrio contains some of the most important intestinal pathogens of humans, including Vibrio cholerae, the cause of epidemic Asiatic cholera. A group of organisms which have been reffered to as the non-agglutinating vibrio (NAG) do not agglutinate in the Vibrio cholerae 0 group 1 antisera, but are indistinguishable from the 0-1 group both chemically and genetically. Non-O-l Vibrio cholerae can cause isolated as well as focal outbreaks of diarrhea, but the volume of fluid loss does not approach that of classic cholera, and the disease is usually self-limiting. These free-living organisms are found world-widely distributed in the environment including sewage, contaminated water, estuaries, seafood and animals. These strains involved in several cases were isolated from the environment and some patients of diarrhea, and a few epidemiologic reports indicated the wide distribution of the strains throughout the country, giving an attention to the role the organisms may play in an outbreak of diarrhea in Korea. More research on the epidemiology, serologic typing and virulence of the group of organisms, should be, therefore, done to obtain a complete understanding of their role in human disease.

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A Case of Subacute Necrotizing Lymphadenitis Associated with Yersinia Infection in a 12 Years Old Child (소아에서 발생한 Yersinia pseudotuberculosis 감염이 동반된 아급성 괴사성 림프절염 1례)

  • Sim, Yoon-Hee;Lim, In Seok;Lee, Dong Keun
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.123-126
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    • 2003
  • Kikuchi disease(subacute necrotizing lymphadenitis), first reported by Kikuchi and Fujimoto in 1972, is a benign self-limiting illness characterized by fever, neutropenia and cervical lymphadenopathy and develops predominantly in young women, especially in Asia. The cause of Kikuchi disease is unknown, but postinfectious(virus or bacteria) hyperimmune reaction has been suggested. Few pediatric cases have been reported. We experienced a case of Kikuchi disease associated with Yersinia pseudotuberculosis infection in 12-year-old girl. After she was admitted with cervical lymphadenopathy and headache, followed by sustained fever with leukopenia. All symptoms and signs did not seem to be responded to antimicobial treatment. Open biopsy of cervical lymph node was performed and showed findings consistent with subacute necrotizing lymphadenitis. Serologic studies were all negative except for Y. pseudotuberculosis. Fever subsided and lymphadenopathy improved after administration of oral steroid for 1 week.

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