• Title/Summary/Keyword: systemic symptoms

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Extensive gingival necrosis and sequestration of the alveolar bone caused by methimazole-induced neutropenia and three-year follow-up

  • Kim, Eun-Cheol;Park, Joon Bong;Hong, Ji-Youn;Kang, Kyung Lhi
    • Journal of Periodontal and Implant Science
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    • v.45 no.2
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    • pp.76-80
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    • 2015
  • Purpose: Methimazole is an anti-thyroid drug that can cause life-threatening neutropenia in rare situations. The aim of this case report is to describe a set of oral complications associated with methimazole-induced neutropenia and the healing of the gingiva after proper treatment. Methods: A 31-year-old female patient hospitalized for systemic symptoms of sore throat and fever and showing extensive gingival necrosis with pain was referred to the Department of Periodontics from the Department of Endocrinology. Methimazole-induced neutropenia was diagnosed based on blood test results and her medical history. Methimazole was discontinued and a range of treatments was administered, including the injection of granulocyte colony stimulating factor. Results: After systemic treatment, the gingiva began to heal as the neutrophil count increased. Approximately one year later, the gingiva had returned to a normal appearance. Twenty-one months after treatment, sequestra of the alveolar bone that had broken through the gingiva were removed. Periodic supportive periodontal treatment has been continued uneventfully. Conclusions: The oral manifestations of gingival necrosis and ulcerations, in combination with systemic symptoms such as fever and sore throat, are the critical signs presented in the early stages of drug-induced neutropenia. Therefore, dentists need to be aware of these oral complications in order to make an accurate diagnosis and to ensure that prompt medical intervention is provided.

Systemic lupus erythematosus (전신성 홍반성 루푸스)

  • Kim, Kwang-Nam
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1180-1187
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    • 2007
  • Systemic lupus erythematosus (SLE) is an episodic, multi-system, autoimmune disease characterized by widespread inflammation of blood vessels and connective tissues and by the presence of antinuclear antibodies (ANAs), especially antibodies to native (double-stranded) DNA (dsDNA). Its clinical manifestations are extremely variable, and its natural history is unpredictable. Untreated, SLE is often progressive and has a significant fatality rate. The most widely used criteria for the classification of SLE are those of the American College of Rheumatology (ACR), which were revised in 1982 and modified in 1997. The presence of four criteria have been diagnosed as a SLE. Rashes are common at onset and during active disease. The oral mucosa is the site of ulceration with SLE. Arthralgia and arthritis affect most children and these symptoms are short in duration and can be migratory. Lupus nephritis may be more frequent and of greater severity in children than in adults. The initial manifestation of nephritis is microscopic hematuria, followed by proteinuria. The most common neuropsychiatric symptoms are depression, psychosis(hallucination and paranoia) and headache. CNS disease is a major cause of morbidity and mortality. Pericarditis is the most common cardiac manifestation. Libman-Sacks endocarditis is less common in children. The most frequently described pleuropulmonary manifestations are pleural effusions, pleuritis, pneunonitis and pulmonary hemorrhage. During the active phase ESR, CRP, gamma globulin, ferritin and anti-dsDNA are elevated. Antibodies to dsDNA occur in children with active nephritis. Antibodies to the extractable nuclear antigens (Sm, Ro/SS-A, La/SS-B) are strongly associated with SLE. Specific treatment should be individualized and based on the severity of the disease. Sepsis has replaced renal failure as the most common cause of death.

Antigenicity of HM10760 in Guinea Pigs

  • Choi, Woo-Hyuck;Lee, Sung-Hak;Lee, Mi-Chael;Chung, Moon-Ku;Kwon, Se-Chang;Lee, Gwan-Sun;Han, Jae-Yong;Koh, Woo-Suk
    • Toxicological Research
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    • v.21 no.3
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    • pp.241-247
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    • 2005
  • HM10760 is a recombinant human erythropoietin that has beer developed as a drug for anemia. In this study, antigenic potential of HM10760 was examined by active systemic anaphylaxis in guinea pigs and passive cutaneous anaphylaxis in a guinea pig-guinea pig system. HM10760 was subcutaneously administered at 0, 2, and $20{\mu}g/kg$ and also as a suspension with adjuvant ($20{\mu}g/kg$ + FCA). Ovalbumin as a suspension with adjuvant was administered to induce positive control responses. In the active systemic anaphylaxis test, no symptoms except rubbing or licking nose and urination that were considered as physiological phenomena were observed at $0{\mu}g/kg$. Four of 5 animals at $2{\mu}g/kg$ and all the 5 animals at $20{\mu}g/kg$ showed cyanosis and lying on side. All animals in the adjuvant mixture group showed relatively mild symptoms such as rubbing or licking nose, urination, and evacuation. In the passive cutaneous anaphylaxis test, 0/5, 3/5, and 5/5 serum samples from the animals immunized with 0, 2, and $20{\mu}g/kg$, respectively, showed positive reactions against HM10760. All 5 sera collected from the animals immunized with an adjuvant mixture contained HM10760-specific antibodies. These results suggest HM10760 have antigenicity in guinea pigs.

Significance of Studying Uihakgyeonneung Written by Dang Jonghae (당종해(唐宗海)의 의학견능(醫學見能)을 학습(學習)하는 의의(意義))

  • Chough, Won-Joon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.1
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    • pp.35-41
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    • 2010
  • Dang Jonghae put in order symptoms to volume one of Uihakgyeonneung by the attack region of illness, to volume two of Uihakgyeonneung by systemic symptoms, and ones peculiar to gynecology and pediatrics to volume three of Uihakgyeonneung. He presented the basis of a differential diagnosis by Yin-Yang, heat and cold, weakness and firmness. He seized the cause and mechanism of a disease obviously and took measures to cope with a disease. These were the result of his rationality that he integrated the Chinese and Western medicine. That is to say, he summarized the voluminous medical books and extracted the essential ones to utilize conveniently, and he made us grasp the essence of medicine to make symptoms concrete. Therefore, we can study this book as the fundamental courses to make use of basic research and clinical medicine.

Clinical Study on Dry Eye Patients (眼乾燥 患者에 對한 臨床的 考察)

  • Hong, Seung-ug;Chae, Byung-yoon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.11 no.1
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    • pp.292-299
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    • 1998
  • I examined 54 patients who had been diagnosed as dry eye or had experienced symptoms of dry eye such as foreign body sense, dry sense, sore sense, pain, etc. and had some results. The results were as follows; 1. In sex, there were more females than males. 2. The age was examined from 19 years to 70 years and 51-60 years was the most. 3. In duration of symptoms, 1-5 years was taken most of the patients. 4. In blood type, O type was dominant comparing other blood types. 5. In warm and cold preference cold was more than warm or tepid. 6. In associated ocular & systemic disease chronic gastritis was the most and the next was chronic conjunctivitis. 7. In main symptoms foreign body sense was the most of them 8. In prescription Gamisamultang(加味四物湯) was most frequently administered to the patients.

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Peripheral Neuropathy in the Orofacial Region after Third Molar Extraction as an Initial Manifestation of Anemia: Two Case Reports

  • Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.44 no.1
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    • pp.40-44
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    • 2019
  • Third molar extraction, one of the important surgical treatments commonly practiced in dentistry, presents various symptoms after surgery ranging from temporary or mild symptoms to permanent or severe complications. However, oral burning pain, dysesthesia, parageusia, dry mouth, headache and pain in multiple teeth are not the common symptoms that patients often complain after dental extraction. Here, the authors report two cases who presented acute neuropathic symptoms mentioned above in the orofacial regions following third molar extraction. At the initial examination, the healing of the tooth sockets of two patients was normal. One patient was diagnosed as megaloblastic anemia associated with Vitamin $B_{12}$ deficiency and was referred to the Department of Hematology for assessing the underlying etiology of anemia. The laboratory test for the other patient revealed microcytic anemia related to iron deficiency. The patient with iron deficiency anemia was successfully treated with iron supplement. These two cases suggest that anemia, as an underlying systemic disease, may be a rare etiology explaining acute onset of peripheral neuropathy in the orofacial regions after third molar extraction and should be considered in the assessment of patients who report neuropathic symptoms after dental extraction.

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.

A Case of ANCA-Negative Generalized Wegener's Granulomatosis (ANCA 음성인 전신성 베게너육아종증 1예)

  • Kim, Seung Kyu;Kwon, Yong-Jin;Park, Heae Surng;Rhee, Kwang Won;Ha, Ji Yoon;Ko, Hee Sung;Kim, Ki Hyun;Byun, Min Kwang
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.17-20
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    • 2013
  • Wegener's granulomatosis is a very rare systemic vasculitis characterized by necrotizing granulomatosis. The detection of antineutrophil cytoplasm antibody (ANCA) is a valuable finding in diagnosing Wegener's granulomatosis because ANCA is positive in approximately 90 percent of patients with active, generalized Wegener's granulomatosis. But ANCA is not necessarily positive to make a diagnosis. A 59-year-old man was transferred to our hospital. He was diagnosed with lung abscess and treated with antibiotics at previous hospital. Initially, the ANCA was negative in immunofluorescence assay but we suspected Wegener's granulomatosis because of systemic inflammatory symptoms. Clinical symptoms deteriorated rapidly so we did bronchoscopic biopsy early. Wegener's granulomatosis was diagnosed according to pathologic finding that reported necrotizing granulomatous inflammation associated with vasculitis. Thus we treated with steroid then clinical symptoms and laboratory findings were improved.

Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome

  • Song, Seung Min;Cho, Min Sung;Oh, Seak Hee;Kim, Kyung Mo;Park, Young Seo;Kim, Dae Yeon;Lee, Sung Gyu
    • Clinical and Experimental Pediatrics
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    • v.56 no.5
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    • pp.224-226
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    • 2013
  • Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resistant Staphylococcus aureus, who presented with non-specific symptoms, which progressed to acute liver failure, displaying the hallmarks of DRESS syndrome. With the presence of aggravated hepatic encephalopathy and azotemia, the patient was refractory to medical treatments, she received a living-donor liver transplantation, and a cure was achieved without any sign of recurrence. Vancomycin can be a cause of DRESS syndrome. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal disease.

A Case Report of a Patient with Guillain-Barre Syndrome Complaining of Limb Weakness and Facial Paralysis That Improved After Korean Medicine Treatment (사지위약감과 안면마비를 주소로 하는 길랑바레 증후군 환자의 한방치료 증례보고 1례)

  • Won, Seo-young;Kim, Hae-yoong;Kim, Jeong-hui;Ryu, Ju-young;Jung, Eun-sun;Yoo, Ho-ryong;Seol, In-chan;Kim, Yoon-sik
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.695-706
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    • 2021
  • Objectives: This study reports a case of Guillain-Barre Syndrome (GBS) in which the patient experienced improved limb weakness, facial paralysis, paresthesia, and systemic pain after Korean medicine treatment. Methods: A 25-year-old female patient diagnosed with GBS received the herbal medicine Banhasasim-tang Soft Ext., acupuncture, electroacupuncture, moxibustion, cupping, and rehabilitation treatment. To confirm the change in symptoms, the manual muscle test (MMT), Korean Version of Modified Barthel Index (K-MBI), Yanagihara grading system (Y-score) and Numeric Rating Scale (NRS) were performed. Results: After Korean medicine treatment, there was a significant improvement in GBS-related clinical symptoms. Conclusions: Korean medicine treatment could be effective in improving symptoms of limb weakness, facial paralysis, paresthesia, and systemic pain related to GBS. However, this study has limitations as a case report, and more studies are needed.