ABSTRACT
There have been several reported cases of acute lymphoblastic leukemia with severe lactic acidosis in adults. In these cases, kidney and liver enlargement that was caused by leukemic infiltration frequently accompanied the acute lymphoblastic leukemia and severe lactic acidosis. Chemotherapy is the only treatment that can rapidly correct the lactic acidosis and normalize the liver and kidney enlargement. We report here on a case of acute lymphoblastic leukemia that was accompanied with severe lactic acidosis and kidney enlargement.
Subject(s)
Adult , Humans , Acidosis, Lactic , Kidney , Leukemic Infiltration , Liver , Precursor Cell Lymphoblastic Leukemia-LymphomaABSTRACT
A 40-year-old woman presented with hemoptysis and thoracocervicofacial purpura that occurred after a generalized tonic-clonic seizure. Diffuse alveolar hemorrhage is reported relatively rarely in neurogenic pulmonary edema (NPE), which is a life-threatening postictal complication. This clinical setting causes difficulty in the diagnosis, when an accurate diagnosis and proper management are required. Thoracocervicofacial purpura has been described as an unusual setting for an epileptic seizure. Here, we report the first case of postictal diffuse alveolar hemorrhage with thoracocervicofacial purpura.
Subject(s)
Adult , Female , Humans , Epilepsy , Hemoptysis , Hemorrhage , Pulmonary Edema , Purpura , SeizuresABSTRACT
We experienced a case of tuberculosis presented simultaneously with pseudoaneurysm of the aorta and ARDS. A 63-year-old man was admitted with complaints of fever and right upper quadrant abdominal pain for a week. Chest X-ray on admission showed a normal finding. Sub-diaphragmatic abscess on abdomen CT scan was suspected and serosanguinous fluid was aspirated from the abscess pocket. On day 2, he was getting more dyspneic and chest X-ray revealed extensive bilateral infiltration. Aspirated fluid revealed AFB. Later, follow-up abdomen CT scan revealed a leakage of dye from the aneurysmal sac of the descending aorta which was previously diagnosed as sub-diaphragmatic abscess. An aortic stent was placed, covering the opening into the aneurysm. The sputum also showed positive AFB. The patient was successfully weaned from the ventilator, and discharged with anti-tuberculous medication on day 42. Follow-up abdomen CT scan 6 months later showed that the aneurymal sac was completely disappeared.
Subject(s)
Humans , Middle Aged , Abdomen , Abdominal Pain , Abscess , Aneurysm , Aneurysm, False , Aorta , Aorta, Thoracic , Fever , Follow-Up Studies , Respiratory Distress Syndrome , Sputum , Stents , Thorax , Tuberculosis , Ventilators, MechanicalABSTRACT
BACKGROUND/AIMS: The purpose of this study was to characterize the clinical features of acute hepatitis A in Seoul and Gyeonggi province during the recent 2 years. METHODS: We reviewed the medical records of 222 patients who were diagnosed as acute hepatitis A between August 2005 and March 2007 at the Konkuk University Hospital and Korea University, Ansan Hospital. The clinical manifestation, serological tests, and image findings were analyzed. RESULTS: Median age of the patients was 28.1 years and the age groups of highest incidence were the second and third decade. The frequent symptoms were anorexia (66.4%), fatigue (49.2%), fever (47.7%), and abdominal discomfort (42.5%). Fourteen cases (6.3%) showed renal insufficiency, and hemodialysis was performed in one. Cholestatic hepatitis in 2 cases, relapsing hepatitis in 4 cases and prolonged hepatitis in 13 cases were observed. However, there was no case of fulminant hepatitis or death. The underlying diseases including chronic hepatitis B, diabetes mellitus and thyroid disorder did not affect the disease severity of hepatitis A. IgM anti-HAV was not detected initially in 6.7% of the patients. Anti-HEV (IgM) was detected simultaneously in 3 of 150 patients. CONCULSIONS: The age of patients with acute hepatitis A has been increased in the recent years. Most patients recovered uneventfully. However, unusual patterns of severe hepatitis and renal insufficiency occurred in considerable number of cases. Follow-up serologic test for IgM anti-HAV is needed in seronegative cases with hepatitis A
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Acute Disease , Age Distribution , Hepatitis A/diagnosis , Hepatitis A Antibodies/metabolism , Hepatitis A Virus, Human/immunology , Immunoglobulin M/blood , Serologic Tests , Suburban PopulationABSTRACT
Scrotal edema may develop during continuous ambulatory peritoneal dialysis (CAPD). The two etiologic mechanisms are peritoneo-scrotal communication through a patent processus vaginalis or extravasation of dialysate through a defect of abdominal wall. We report two cases of scrotal edema due to inguinal hernia by peritoneo-scrotal communication during CAPD. The etiology of scrotal edema was confirmed by peritoneal scintigraphy and/or computed tomography. Scrotal edema due to inguinal hernia was completely resolved by a surgical repair of hernia and did not recur despite of resumption of peritoneal dialysis.
Subject(s)
Humans , Abdominal Wall , Edema , Hernia , Hernia, Inguinal , Peritoneal Dialysis , Peritoneal Dialysis, Continuous Ambulatory , Testicular HydroceleABSTRACT
Gastrointestinal leiomyomas are commonly found in the stomach, and but 3% of them arises from the colon. Colonic leiomyomas are often found incidentally during colonoscopic examination. Most of patients with colonic leiomyoma are asymptomatic, but patients with large size leiomyoma occasionally have abdominal mass, hemorrhage, intestinal obstruction or perforation. Pedunculated leiomyomatous polyp is rare. Leiomyomatous polyps are occasionally misjudged as adenomatous polyps by endoscopist. We report a case of pedunculated leiomyomatous colonic polyp in 65 year-old female patient. She has complained of intermittent hematochezia and lower abdominal discomfort for 5 months. During colonoscopy, an 1 cm sized long pedunculated polyp at the splenic flexure was detected. It was removed by colonoscopic snare polypectomy. Leiomyomatous polyp was confirmed by microscopic and immunohistochemical findings.
Subject(s)
Aged , Female , Humans , Anal Canal , Colonic Neoplasms/complications , Colonoscopy , English Abstract , Gastrointestinal Hemorrhage/etiology , Leiomyoma/complicationsABSTRACT
Immunosuppressive medications after renal allograft transplantation have impacted the course of acute and chronic rejection: however, they have no defined effects on the prevention of recurrent and Glomerulonephritis (GN) in an allograft kidney. Authors experienced a case of rapidly progressive glomerulonephritis (RPGN). The 35-year-old female patient developed a rapid deterioration of renal function 4 years after renal transplantation. The allograft biopsy showed crescentic glomerulonephritis evolving from membranoproliferative glomerulonephritis (MPGN) type I. She was given pulse steroid and oral cyclophosphamide therapy immediately after the renal biopsy. Graft function stabilized and proteinuria decreased even though graft function did not recover to pre-treatment level and low grade proteinuria persisted.