Recurrent Systemic Capillary Leak Syndrome Responding to the Corticosteroid Therapy / 대한신장학회지

Systemic capillary leak syndrome (SCLS) is a rare devastating condition that is caused by unexplained marked capillary hyperpermeability, resulting in hypovolemic shock, hemoconcentration, and hypoproteinemia. Most patients have prodromal symptoms such as non-specific gastrointestinal symptoms, myalgia, or dizziness. In the current case, we observed the patient with recurrent SCLS show perivascular lymphocytic infiltration on skin biopsy and eosinophilic infiltrates on random biopsies from duodenum to colon. This finding might be due to distinct eosinophilic enterocolitis or secondary to SCLS. However, there has been rare data for the prevention of the recurrent attack of SCLS, although the mortality is high. Therefore, we report a case of frequently relapsing SCLS responding to the corticosteroid therapy.

A case of infective endocarditis caused by Streptococcus agalactiae, in a patient with advanced gastric cancer / 대한내과학회지

The epidemiology of Group B streptococcal disease has been changing. Since the 1990s, early-onset neonatal and maternal peripartum infections have decreased, due to the administration of prophylactic intrapartum antibiotics. On the other hand, invasive Group B streptococcal infections have increased in nonpregnant adults, especially in elderly persons and in those with chronic immunosuppressive diseases, such as diabetes mellitus, liver cirrhosis, and malignancies. Although infective endocarditis is an uncommon manifestation of invasive Streptococcus agalactiae infection, it usually leads to cardiac surgery, due to heart failure associated with rapid valve destruction and the formation of emboli. Several cases of endocarditis due to S. agalactiae have appeared in the literature, but there have been few reports in Korea. We present a case of S. agalactiae infective endocarditis in an elderly patient with advanced gastric cancer, successfully treated with intravenous antibiotics and cardiac surgery.

A case of infective endocarditis caused by Streptococcus agalactiae, in a patient with advanced gastric cancer / 대한내과학회지

The epidemiology of Group B streptococcal disease has been changing. Since the 1990s, early-onset neonatal and maternal peripartum infections have decreased, due to the administration of prophylactic intrapartum antibiotics. On the other hand, invasive Group B streptococcal infections have increased in nonpregnant adults, especially in elderly persons and in those with chronic immunosuppressive diseases, such as diabetes mellitus, liver cirrhosis, and malignancies. Although infective endocarditis is an uncommon manifestation of invasive Streptococcus agalactiae infection, it usually leads to cardiac surgery, due to heart failure associated with rapid valve destruction and the formation of emboli. Several cases of endocarditis due to S. agalactiae have appeared in the literature, but there have been few reports in Korea. We present a case of S. agalactiae infective endocarditis in an elderly patient with advanced gastric cancer, successfully treated with intravenous antibiotics and cardiac surgery.

A case of acute human immunodeficiency virus syndrome presenting as aseptic meningitis / 대한내과학회지

Acute human immunodeficiency virus (HIV) syndrome develops in 40 to 90% of new HIV-1 infections. In Korea, recent increases in HIV-1 infection rates suggest that the number of patients experiencing acute HIV syndrome will also increase. Furthermore, it has been reported that aseptic meningitis occurs in 24% of patients with acute HIV syndrome. The inclusion of acute HIV syndrome in the differential diagnosis of aseptic meningitis is crucial; however, few reports of acute HIV syndrome presenting as aseptic meningitis in Korea exist. Here we report a case of aseptic meningitis in a patient who received early antiretroviral therapy after a diagnosis of acute HIV syndrome.

A case of acute human immunodeficiency virus syndrome presenting as aseptic meningitis / 대한내과학회지

Acute human immunodeficiency virus (HIV) syndrome develops in 40 to 90% of new HIV-1 infections. In Korea, recent increases in HIV-1 infection rates suggest that the number of patients experiencing acute HIV syndrome will also increase. Furthermore, it has been reported that aseptic meningitis occurs in 24% of patients with acute HIV syndrome. The inclusion of acute HIV syndrome in the differential diagnosis of aseptic meningitis is crucial; however, few reports of acute HIV syndrome presenting as aseptic meningitis in Korea exist. Here we report a case of aseptic meningitis in a patient who received early antiretroviral therapy after a diagnosis of acute HIV syndrome.

A Case of Thyroid Cancer Combined with Pulmonary Sarcoidosis / 결핵및호흡기질환

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. Since Brincker first noted a statistically significant increase of malignant tumors among sarcoidosis patients, there have been several reports on simultaneously developed sarcoidosis and malignancy. A 30-year-old man was admitted to our hospital because of multiple enlarged mediastinal lymph nodes. The patient had been well until approximately 10 days before admission, when he developed a cough. Chest X-ray and computed tomography (CT) of the chest that were performed at the outpatient department revealed multiple enlarged mediastinal lymph nodes. Cervical lymph node biopsy revealed both non-caseating granuloma and metastatic papillary carcinoma, whereas the mediastinal lymph node showed only non-caseating granuloma. The thyroid gland surgical specimen showed papillary carcinoma. We report here on a case of a 30-year-old man who had sarcoidosis and thyroid cancer, and we include a review of the literature.

A Case of Ankylosing Spondylitis in a Patient with Henoch-Schonlein Purpura / 대한류마티스학회지

Ankylosing spondylitis (AS) is a common inflammatory arthritis that affects the axial skeleton, causing characteristic inflammatory back pain, which can lead to structural and functional impairments and a decrease in quality of life. The disease can be accompanied by extraskeletal manifestations, such as acute anterior uveitis, inflammation in the colon or ileum, aortic insufficiency, cardiac conduction defects, fibrosis of the upper lobes of the lungs, neurologic involvement, or renal (secondary) amyloidosis. We report the case of a 19 year-old man who developed Henoch-Schonlein purpura (HSP) and subsequently AS. It has been recognized that AS may be associated with cutaneous vasculitis and IgA nephropathy, but the association of HSP with AS has not been reported. This association of IgA nephropathy or HSP with AS raises the possibility of a common or related pathogenesis.

A Case of Small Intestinal Obstruction due to Bezoars Accompanied with Sump Syndrome / 대한소화기내시경학회지

Sump syndrome is one of the late complications of a side to side choledochoduodenostomy, but it is a rare malady. The anastomosis of the bile duct and small bowel results in exclusion of the distal limb of the common bile duct from drainage of bile with the potential formation of a sump. Food material and bile sludge may accumulate in distal segment of common bile duct and so this cause recurrent bile duct stones. Bezoars frequently result from disturbed passage of the gastrointestinal tract, especially after surgery, and it may develop various symptoms by irritating or obstructing the gastrointestinal tract. The bezoar accompanied with sump syndrome after choledochoenterostomy has not yet been reported in the literature. We report here on a case of small intestinal obstruction due to bezoars accompanied with sump syndrome.