A Case of Carcinoid Tumor in a Patient with Focal Segmental Glomerulosclerosis / 대한신장학회잡지

A renal lesion of neoplasm-related nephrotic syndrome usually presents as membranous nephropathy. Neoplasm-related nephrotic syndrome exhibiting focal segmental glomerulosclerosis (FSGS) has been reported mainly in patients with hematological malignancies. But reports of an association between FSGS and neoplasm are extremely rare. We report a 66-year-old woman with FSGS who presented with nephrotic syndrome and was subsequently found to have carcinoid tumors in the duodenum, confirmed by tissue biopsy. After resection of carcinoid tumor, the patient received initial treatment with oral prednisolone for 2 months but her nephrotic syndrome persisted. The patient was then treated with oral cyclophosphamide. One month later, she was in complete remission of nephrotic syndrome as indicated by a normal serum albumin and no proteinuria. This case may be a coincidence or the lesions may be linked with each other but since little is known about the pathogenesis of FSGS and neoplasm, it is difficult to speculate on a pathogenetic link between these two lesions. We report a case of FSGS with nephrotic syndrome in a patient with carcinoid tumor.

Efficacy of ten days of clarithromycin, amoxicillin and omeprazole in eradicating Helicobacter pylori infection / 대한내과학회지

OBJECTIVE: Eradication of H. pylori not only results in ulcer healing, but reduces recurrences essentially curing peptic ulcer disease. The purpose of this study was to evaluate the eradication rate of H. pylori and side effects with regard to three drug regimens. METHODS: 96 patients were included and divided into three groups: 14 patients(group 1: OA) received omeprazole(20 mg b.i.d.) and amoxicillin(1.0 gm b.i.d.) for 14 days ; 12 patients (group 2: BAM) received colloidal bismuth subcitrate(CBS)(120 mg b.i.d.), amoxicillin(500 mg q.i.d.) and metronidazole(250 mg q.i.d.) for 14 days. ; 70 patients(group 3: OAC) received omeprazole(20 mg b.i.d.), amoxicillin(500 mg q.i.d.) and clarithromycin(250 mg q.i.d.) for 10 days. The diagnosis of the status of H. pylori was made by histology or culture or rapid urease test(CLO test). RESULTS: 1) The eradication rate of H. pylori was higher group 2(91.7%) and group 3(91.4%) than group 1(57.1%). 2) The total failure rate regardless of the regimens (n=96) was 13.5%(13 patients). 10 patients whose treatment failed were randomly assigned to receive retreatment with the alternative regimen of BAM or OAC. In retreatment group(n=10), the eradication rate of H. pylori infection was achieved in 100 %. 3) The side effects were oral burning sensation, odynophagia, nausea, epigastric pain, diarrhea, constipation, gas bloating. The side effects were negligible. CONCLUSIONS: 10-day therapy with omeprazole, amoxicillin and clarithromycin(OAC) achieved eradication rate of 91.4 %. The side effects were few and negligible. 10-day therapy with OAC was a safe and very effective regimen for the eradication of H. pylori infection.