ABSTRACT
Periorbital edema is a rare manifestation of systemic lupus erythematosus (SLE). We describe here a patient with bilateral periorbital edema as a presenting symptom of SLE. A 23-year-old woman was admitted for a sudden onset of severe periorbital edema that developed 7 days previously. On the basis of the malar rash, arthritis of the right hand and left wrist, leukopenia, proteinuria and the positive anti-nuclear and anti-dsDNA antibodies, she was diagnosed with SLE. Kidney biopsy revealed lupus nephritis (WHO class IV). After treatment with high dose of steroids, intravenous cyclophosphamide and daily hydroxychloroquine, her symptoms resolved, including the periorbital edema. She was discharged with prescriptions for prednisolone and hydroxychloroquine and she remains well.
Subject(s)
Female , Humans , Young Adult , Antibodies , Arthritis , Biopsy , Cyclophosphamide , Edema , Exanthema , Hand , Hydroxychloroquine , Kidney , Leukopenia , Lupus Erythematosus, Systemic , Lupus Nephritis , Prednisolone , Prescriptions , Proteinuria , Steroids , WristABSTRACT
Scrub typhus, which is caused by Orientia tsutsugamushi, is an acute febrile illness characterized by fever, rash, and myalgia. Recently, its incidence in Korea has increased. Many cases of scrub typhus with central nervous system involvement have been reported, while cases with hearing loss are rare. We experienced a case of scrub typhus with reversible hearing loss. To our knowledge, this is the first case confirmed by magnetic resonance imaging.
Subject(s)
Central Nervous System , Exanthema , Fever , Hearing , Hearing Loss , Incidence , Korea , Magnetic Resonance Imaging , Orientia tsutsugamushi , Scrub TyphusABSTRACT
Scrub typhus, which is caused by Orientia tsutsugamushi, is an acute febrile illness characterized by fever, rash, and myalgia. Recently, its incidence in Korea has increased. Many cases of scrub typhus with central nervous system involvement have been reported, while cases with hearing loss are rare. We experienced a case of scrub typhus with reversible hearing loss. To our knowledge, this is the first case confirmed by magnetic resonance imaging.
Subject(s)
Central Nervous System , Exanthema , Fever , Hearing , Hearing Loss , Incidence , Korea , Magnetic Resonance Imaging , Orientia tsutsugamushi , Scrub TyphusABSTRACT
Vitamin D insufficiency may be associated with cardiovascular (CV) mortality in HD patients. To test this hypothesis, we cross-sectionally measured 25-hydroxyvitamin D (25D), 1,25-dihydroxyvitamin D (1,25D), cardiac troponin T (cTnT), and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) in chronic HD patients. Sixty-five patients (M:F=31:34, age 52.2+/-13.2 yr, DM 41.5%) were selected. Along with the expected low levels of 1,25D, 59 (90.8%) patients had 25D insufficiency (<30 ng/mL) among whom 15 (23.1%) were 25D deficient (<10 ng/mL). The 25D levels showed a negative correlation with cTnT levels (Spearman's rho=-0.44, p<0.01) but not with NT-pro-BNP levels (Spearman's rho=-0.17, p=0.17). The 1,25D levels, however, did not show any relationship with either cTnT or NT-pro-BNP. In multivariate analysis, being male and having low levels of 25D were independent risk factors associated with cTnT elevation (beta=0.44, p<0.01 and beta=-0.48, p<0.01, respectively). In conclusion, not only 1,25D but also 25D are commonly decreased in HD patients. Lower 25D levels appear to be associated with cTnT elevation, predicting worse CV outcome, and are possible to involve cardiac hypertrophy or coronary artery disease.
Subject(s)
Female , Humans , Male , Middle Aged , Biomarkers/blood , Coronary Artery Disease/blood , Electrocardiography/methods , Heart Diseases/blood , Multivariate Analysis , Nerve Tissue Proteins/blood , Protein Precursors/blood , Renal Dialysis/methods , Risk Factors , Troponin T/blood , Vitamin D/bloodABSTRACT
BACKGROUND: Bronchiectasis (BE) remains a rare respiratory disease in Korea. This retrospective study was done to investigate the potential pathogenic microorganisms (PPMs) that cause in patients with BE, through the use of sputum specimens. METHODS: One hundred eleven adult patients, who had undergone chest computed tomography (CT), sputum gram stain/culture, and BE detected by chest CT, were included in this study. Sputum adequacy was determined by using Murray-Washington classification. RESULTS: The mean (+/-SD) age of patients was 60.9 (+/-14.0). The number of PPMs was 167 (67%) in the total 248 isolated organisms. The most frequent PPMs were P. aeruginosa (23.4%), K. pneumoniae (10.5%), and S. aureus (8.4%). The proportion of adequate sputum (AS) was 25.8% in the total sputum specimens. The patients with AS were 41 (37%) and the patients with inadequate sputum (IS) were 70 (63%). The proportion of P. aeruginosa was higher in AS compared to that of IS (44% vs. 19%, p=0.004). The BE score was also higher in P. aeruginosa (+) patients compared to that of P. aeruginosa (-) patients (10.8 vs. 7.6, p=0.001). CONCLUSION: Although the proportion of AS in the total sputum was low, PPMs were isolated in most patients with BE. It is likely that P. aeruginosa was isolated in AS and AS patients had higher BE scores.