ABSTRACT
Cholesterol crystal embolism caused by showers of cholesterol emboli from an atherosclerotic aorta is a multisystem disorder that affects many organs. Common signs and symptoms on presentation include skin findings and renal failure. However, myositis due to a cholesterol embolism is uncommon. We report a rare case of cholesterol crystal embolism that presented with features of focal and foot necrosis in an 83-year-old woman.
Subject(s)
Female , Humans , Aorta , Cholesterol , Embolism , Embolism, Cholesterol , Foot , Myositis , Necrosis , Renal Insufficiency , SkinABSTRACT
Ramsay Hunt syndrome associated with the Varicella zoster virus (VZV) infection is characterized by vesicles on the pinna, otalgia, facial nerve palsy and sensorineural hearing loss. Although significant complications from VZV infection are increasing, thrombosis associated with VZV infection is one of the rare complications in adults. The VZV itself could cause endothelial damage in the various organs. Subsequently, the thrombosis might be complicated. A previously healthy 84 year-old female patient was diagnosed with Ramsay Hunt syndrome. On the 7th day of antiviral treatment, she complained of sudden breathlessness. She was hypoxemic with an elevated alveolar-arterial oxygen difference and needed to be supported by mechanical ventilation. Massive pulmonary thrombosis was documented by computerized tomography and she successfully underwent thrombolytic therapy. We report a case of massive pulmonary thromboembolism associated with VZV infection, treated with thrombolytic therapy.
Subject(s)
Adult , Female , Humans , Earache , Facial Nerve , Hearing Loss, Sensorineural , Herpes Zoster , Herpes Zoster Oticus , Herpesvirus 3, Human , Oxygen , Paralysis , Parkinsonian Disorders , Pulmonary Embolism , Respiration, Artificial , Thrombolytic Therapy , ThrombosisABSTRACT
Anisakidae larvae can cause anisakiasis when ingested by humans. Although several groups have reported a gastrointestinal Anisakis allergy among people in Spain and Japan, our report is the first to summarize the clinical features of 10 Anisakis allergy cases in Korea. We enrolled 10 Korean patients (6 men and 4 women) who complained of aggravated allergic symptoms after ingesting raw fish or seafood. Sensitization to Anisakis was confirmed by detecting serum specific IgE to Anisakis simplex. The most common manifestation of anisakiasis was urticaria (100%), followed by abdominal pain (30%) and anaphylaxis (30%). All patients presenting with these symptoms also exhibited high serum specific IgE (0.45 to 100 kU/L) to A. simplex. Nine patients (90%) exhibited atopy and increased total serum IgE levels. The fish species suspected of carrying the Anisakis parasite were flatfish (40%), congers (40%), squid (30%), whelk (10%), and tuna (10%). Anisakis simplex should be considered as a possible causative food allergen in adult patients presenting with urticaria, angioedema, and anaphylaxis following the consumption of raw fish or seafood.
Subject(s)
Adult , Aged , Animals , Female , Humans , Male , Middle Aged , Young Adult , Abdominal Pain/immunology , Anaphylaxis/immunology , Angioedema/immunology , Anisakiasis/complications , Anisakis/immunology , Antibodies, Helminth/blood , Asian People , Food Hypersensitivity/complications , Immunoglobulin E/blood , Korea/epidemiology , Seafood/adverse effects , Urticaria/immunologyABSTRACT
BACKGROUND AND OBJECTIVES: Tetranychus urticae(TU) is a widely distributed parasitic mite found on fruit trees and green house flowers. A recent investigation demonstrated that TU inhalation causes allergic asthma even in non-farmers. We tried to evaluate skin reactivity and specific IgE sensitization to TU, identify IgE binding components, and evaluate allergenic rela- tionship with house dust mite(HDM). MATERIALS AND METHODS: We carried out skin prick test with TU in 1806 respiratory allergy patients over 1 year living in urban and rural areas. ELISA was performed for detection of specific IgE antibody. To evaluate the cross allergenicity between TU and HDM, ELISA inhibition test was carried out with two kinds of pooled sera ; serum pool A included patients' sera sensitized to both TU and HDM, and serum pool B included sera sensitized only to TU. To identify IgE binding components, SDS-PAGE followed by IgE-immunoblot were applied. RESULTS: 358 patients(19.8%) showed positive response(A/H > or = 2+) on skin prick test. Twelve patients showed isolated positive response to TU. Specific IgE was detected in sixty patients(54.5%) out of 110 sensitized patients. ELISA inhibition test using two sera pools (A and B) showed significant inhibitions by TU with minimal inhibitions by HDM. SDS-PAGE and IgE-immunoblot with patients' individual sera sensitized to both TU and HDM showed 10 IgE binding components (67kD, 29kD, 27kD, 10kD, 14kD, 39kD, 46kD, 35kD, 72kD, 77kD) and two(67kD and 29kD) were bound to IgE in more than 50% of sera tested. In patients' sera sensitized only to TU, nine IgE binding components(67kD, 10kD, 14kD, 29kD, 39kD, 46kD, 72kD, 77kD, 9kD) were found and two(67kD and 10kD) were bound to IgE in more than 50%. CONCLUSION: Of allergy patients visiting the Allergy Clinic, 19.8% were sensitized to TU and specific IgE was detected in 54.5% of them. No cross allergenicity was noted between TU and HDM. Eleven IgE binding components and three (67kD, 10kD and 29kD) major allergens were identified.
Subject(s)
Humans , Allergens , Asthma , Dust , Electrophoresis, Polyacrylamide Gel , Enzyme-Linked Immunosorbent Assay , Flowers , Fruit , Hypersensitivity , Immunoglobulin E , Inhalation , Mites , Pyroglyphidae , Skin , TreesABSTRACT
Systemic lupus erythematosus(SLE) is the prototypic immune complex disease which involves various organs. Chronic interstitial cystitis and protein-losing enteropathy are uncommon manifestations of SLE and have good response to steroid. Only one case of SLE associated with chronic interstitial cystitis and protein-losing enteropathy has been reported which was resistant to steroid treatment but dramatically responded to cyclophosphamide. We describe a case of a female patient who developed systemic lupus erythematosus associated with chylothorax, interstitial cystitis and protein-losing enteropathy with literature review. This case was initially resistant to steroid but with the addition of cyclophosphamide, chylothorax, chronic interstitial cystitis and protein-losing enteropathy markedly improved. This is the first case of SLE that developed chylothorax as well as chronic interstitial cystitis and protein-losing enteropathy.
Subject(s)
Female , Humans , Chylothorax , Cyclophosphamide , Cystitis, Interstitial , Immune Complex Diseases , Lupus Erythematosus, Systemic , Protein-Losing EnteropathiesABSTRACT
Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a skeletal disease characterized by ligamentous ossification of the anterolateral side of the spine. Paravertebral and ligamentous ossification appears to be an usual complication of hypoparathyroidism. Diabetes Mellitus has often been mentioned in associated with DISH. The patient was presented with back pain, stiffness and intermittent numbness of hands and feet. Spine X-ray showed extensive ligamentous ossification of the anterolateral side of the spine with normal disc space height. Sacroiliac joints are normal. Increased bone mineral density of the L-spine and femur neck was observed, as well. Hypocalcemia, hyperphophatemia and low intact parathyroid hormone level were detected. Postprandial sugar were elevated. HLA B27 was negative.
Subject(s)
Humans , Back Pain , Bone Density , Diabetes Mellitus , Femur Neck , Foot , Hand , Hyperostosis, Diffuse Idiopathic Skeletal , Hypesthesia , Hypocalcemia , Hypoparathyroidism , Ligaments , Parathyroid Hormone , Sacroiliac Joint , SpineABSTRACT
Hyperparathyroidism due to parathyroid cancer is rare. It is difficult to diagnose preoperatively but there should be an increased index of suspicion in those parathyroid Patient with palpable neck masses, profound hypercalcemia(greater than 14mg/dl), made increase of the parathyroid hormone level to greater than twice normal, and significant metabolic complications. In parathyroid cancer, systemic calcinosis is an extremely rare manifestation. The most common metastatic calcification site is lung and the other involved site is stomach, liver, skin and heart. After resection of parathyroid tumor, this systemic calcinosis is self-limiting. We experienced a patient with primary hyperparathyroidsm, presented with metastatic calcification in the lung and stomach disappeared by successful parathyroidectomy.
Subject(s)
Humans , Calcinosis , Heart , Hypercalcemia , Hyperparathyroidism , Liver , Lung , Neck , Parathyroid Hormone , Parathyroid Neoplasms , Parathyroidectomy , Skin , StomachABSTRACT
South Korea has been free from endemic malaria by P. vivax since the mid-1980s, but malaria infections, including military outbreak in 1995, have been increasing steadily in the soldiers serving near the western part of Demilitarized Zone(DMZ) since its first resurgence in 1993. We experinced 8 cases of delayed onset P. vivax malaria in young men who had never been abroad and had no history of blood transfusion or parenteral use of drug. All the patients had served near the western part of DMZ during their military life. They were admitted to Yeungnam University hospital due to cyclic fever with chills and the clinical symptoms were developed 2 months to 11months after discharge from military service. Peripheral blood smears showed typical ring forms and trophozoites of P. vivax in red blood cell. Patients were treated with hydroxychloroquine and primaquine showing rapid clinical and hematologic responses in all cases, but 2 cases were relapsed later. We presumed that theses cases were delayed onset of P. vivax infection resulted from the recent outbreak in the western part of DMZ, in 1995. Therefore, we reported theses cases to emphasize the need of active surveillance and prevention.