ABSTRACT
Anti-glomerular basement membrane antibody mediated rapidly progressive glomerulonephritis(anti- GBM antibody mediated RPGN) is defined by the clinical picture of renal failure developing over days or weeks and the histological appearance of crescents and linear immune deposits mediated by the circulating autoantibodies. We report a case of anti-GBM antibody mediated RPGN with review of literature. A 59-year-old female patient was admitted to the Chungang Gil Hospital because of fever and acute deterioration of renal function. On admission, hemoglobin was 7.39g/dL, hematocrit was 20.9%, and BUN/Cr were 39.7 and 5.23mg/dL respectively. Urinalysis showed albumin (1+) with many RBCs. Renal biopsy revealed the presence of segmental or circumferential cellular crescents associated with smooth linear staining of glomerular basement membrane with antibody to IgG. High titer of circulating antibody to glomerular basement membrane antigen was demonstrated by the ELISA. High doses of corticosteroid with plasmapheresis were administered, but her renal function was progressively deteriorated.
Subject(s)
Female , Humans , Middle Aged , Autoantibodies , Basement Membrane , Biopsy , Enzyme-Linked Immunosorbent Assay , Fever , Glomerular Basement Membrane , Glomerulonephritis , Hematocrit , Immunoglobulin G , Plasmapheresis , Renal Insufficiency , UrinalysisABSTRACT
Typhlitis is a life threatening necrotizing enterocolitis of the cecum, ascending colon and terminal ileum seen in severely neutropenic patients, however its pathogenesis is not identified up to this time.The incidence of typhlitis in leukemic patient is 10~12%, estimated by postmortem examination, and 46% in induction chemotherapy of leukemia. Recently, entity incidence is more high due to increasing challenges to high dose chemotherapy in solid tumors.We experienced four cases of typhlitis, one was developed in the circumstance of neutropenia induced by induction chemotherapy for acute myelocytic leukemia and others in neutropnia due to primary diseases without chemotherapy, ig, chronic myelocytic leukemia, acute lymphocytic leukemia, myelodysplastic syndrome.All cases were treated with high dose broad spectrum antibiotics in early phase of disease and its outcome was good, so that, early diagnosis of typhlitis is essential, then prompt treatment with high dose antibiotics and intravenous fluid before onset of transmural necrosis is associated with lower morbidity and mortality than surgical resection.
Subject(s)
Humans , Anti-Bacterial Agents , Autopsy , Cecum , Colon, Ascending , Drug Therapy , Early Diagnosis , Enterocolitis, Necrotizing , Ileum , Incidence , Induction Chemotherapy , Leukemia , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Leukemia, Myeloid, Acute , Mortality , Necrosis , Neutropenia , Precursor Cell Lymphoblastic Leukemia-Lymphoma , TyphlitisABSTRACT
Metastatic tumor of the epididymis is a rare tumor. There are around 31 cases in the literature until now. The primary tumor was from the prostate in 18 cases, large and small intestine in 6 cases, kidney in 4 cases, stomach in 2 cases and pancreas in 1 case. We recently experienced a case of metastatic carcinoma to the epididymis from a primary cancer in the sigmoid colon and the other case of metastatic carcinoma to the testis and the liver from a sigmoid adenocarcinoma.