ABSTRACT
Since 1897 when Poncet first described polyarthritis in the acute stage of extra-articular tuberculosis, Poncet's disease has been considered a reactive arthritis to Mycobacterium tuberculosis. It is characterized by polyarthritis without evidence of direct mycobacterial involvement in patients with active tuberculosis, and eventually resolves without residual joint damage. Even though Poncet's disease is uncommon, the distinction between Poncet's disease and other arthritis, including tuberculous arthritis is clinically important. We report the second case of Poncet's disease diagnosed in a patient with pulmonary tuberculosis in Korea and review the relevant literature.
Subject(s)
Humans , Arthritis , Arthritis, Reactive , Joints , Korea , Mycobacterium tuberculosis , Tuberculosis , Tuberculosis, PulmonaryABSTRACT
Wegener's grandulomatosis (WG) is a systemic small-vessel vasculitis characterized by necrotizing granulomatous lesions and anti-neutrophil cytoplasmic antibodies (ANCA). WG frequently affects the upper and lower respiratory tracts and kidney but involvement of the pachymeninges or large vessels has rarely been reported. We report the first case of WG with periaortitis and pachymeningitis in Korea. A 57-year-old female complained of a stabbing headache, paresthesia below the thoracic 4th nerve level, and lower extremity weakness. During her course, she developed otitis media with sensorineural hearing loss, nodular scleritis, and microhematuria. A neuroimaging study showed an intradural mass in the area from the cervical 7th spine to the thoracic 5th spine, left cerebral convexity, and the left petrous area. A chest computed tomography scan revealed an enhanced and thickened aortic arch. A dural biopsy showed necrotizing granulomatous inflammation, and anti-MPO ANCA was positive. Under a diagnosis of WG, she received high-dose glucocorticoid and oral cyclophosphamide with improvement.
Subject(s)
Female , Humans , Middle Aged , Antibodies, Antineutrophil Cytoplasmic , Aorta, Thoracic , Biopsy , Cyclophosphamide , Headache Disorders, Primary , Hearing Loss, Sensorineural , Inflammation , Kidney , Korea , Lower Extremity , Meningitis , Neuroimaging , Otitis Media , Paresthesia , Respiratory System , Scleritis , Spine , Thorax , Vasculitis , Granulomatosis with PolyangiitisABSTRACT
Cogan's syndrome can accompany a variety of systemic vasculitides including aortitis. A 45-year-old woman with a history of typical Cogan's syndrome presented with orthopnea and exertional dyspnea. Echocardiography demonstrated severe aortic valve insufficiency. Computed tomographic angiography demonstrated active vasculitis affecting the ascending and descending aortas and also showed stenosis of the left subclavian artery, both renal arteries, the celiac axis, the superior mesenteric artery, and the right common iliac artery. She received high dose corticosteroid and then underwent an aortic valve replacement. This is the first case of Cogan's syndrome with aortitis in Korea.
Subject(s)
Female , Humans , Middle Aged , Angiography , Aorta, Thoracic , Aortic Valve , Aortic Valve Insufficiency , Aortitis , Arthritis , Axis, Cervical Vertebra , Cogan Syndrome , Constriction, Pathologic , Dyspnea , Echocardiography , Iliac Artery , Korea , Mesenteric Artery, Superior , Renal Artery , Subclavian Artery , Systemic Vasculitis , VasculitisABSTRACT
Chronic inflammatory demyelinating polyneuropathy (CIDP) is characterized by symmetrical weakness, impaired sensation, absent or diminished tendon reflexes, an elevated cerebrospinal fluid protein level and nerve-conduction studies that show demyelination. The occurrence of CIDP in patients with systemic lupus erythematosus (SLE) has been rarely reported. We experienced a case of a 33 year-old woman with SLE and she presented with fever, abdominal pain, a tingling sensation of both of her hands and feet, and symmetrical weakness in both the proximal and distal extremities. Her symptoms had persisted for over 1 months before she visited our department. The CSF examination showed an elevated protein level and the nerve conduction studies revealed demyelination. Her symptoms showed minimal improvement with high dose steroid and immunoglobulin therapy, but she responded to cyclophosphamide therapy.
Subject(s)
Female , Humans , Abdominal Pain , Cyclophosphamide , Demyelinating Diseases , Extremities , Fever , Foot , Hand , Hypesthesia , Immunization, Passive , Lupus Erythematosus, Systemic , Neural Conduction , Polyneuropathies , Polyradiculoneuropathy, Chronic Inflammatory Demyelinating , Reflex, Stretch , SensationABSTRACT
Polymyositis is an inflammatory connective tissue disease involving, predominantly, skeletal muscle. Occasionally, it is complicated by serious interstitial pneumonia. The presence of interstitial pneumonia affects the prognosis and contributes substantially to the morbidity and mortality. Although the treatment recommendations for interstitial pneumonia in polymyositis are still not optimal, high-dose steroid or immunosuppressive agents such as methotrexate, azathioprine, cyclosporine A, or cyclophosphamide alone or in combination are effective in myositis-associated interstitial pneumonia in many cases. Nevertheless, the relative frequency of complications, such as opportunistic infection, steroid-induced myopathy, and steroid psychosis, limits the use of high-dose steroid or immunosuppressive regimens. Here, we describe our experience of combination treatment with a steroid inhaler and low-dose cyclophosphamide in a patient with bronchiolitis obliterans organizing pneumonia associated with polymyositis who developed steroid-induced myopathy during initial high-dose steroid and cyclosporine A treatment.
Subject(s)
Humans , Azathioprine , Bronchiolitis , Bronchiolitis Obliterans , Connective Tissue Diseases , Cryptogenic Organizing Pneumonia , Cyclophosphamide , Cyclosporine , Immunosuppressive Agents , Lung Diseases, Interstitial , Methotrexate , Muscle, Skeletal , Muscular Diseases , Nebulizers and Vaporizers , Opportunistic Infections , Polymyositis , Prognosis , Psychotic DisordersABSTRACT
OBJECTIVE: Telemedicine uses common technologies that provide a conduit for information exchange between physicians nurses and patients. In addition to patient records, medical professionals can obtain vital signs and other reference data through telemedicine applications. also, recent advancement in RF technology and wireless communications has enabled the development of noble networks. Mobile telemedicine involves more than just communicating via mobile phone of PDA that sends and receives medical data on Portable Internet. METHODS: This paper describes the design of a mobile telemedicine PDA prototype based on Embedded Linux that can be used to monitor the medical information using a single board computer(SBC). RESULTS: The device hardware architecture consist of signal conditioning circuit, single chip micro-controller, LCD display and wireless network interface card(W-NIC). Embedded Linux was ported as its operating system and application software was developed QT/embedded 2.3.7. CONCLUSION: This system would be very useful for patients with chronic illness, especially in an emergent environment, and for containing medical cost in the aged society.