Eosinophilic Gastritis Presenting as Tissue Necrosis

Eosinophilic gastroenteritis is very rare disorder that is characterized by eosinophilic infiltration of the gastrointestinal tract in the absence of any definite causes of eosinophilia. It is associated with various clinical gastrointestinal manifestations, and depends on the involved layer and site. We report a case of eosinophilic gastritis presenting with severe necrosis. The symptoms disappeared immediately after beginning steroid treatment, and the eosinophil count decreased to the reference range. The patient showed eosinophilic gastritis characterized by necrotic change such as necrotizing gastritis. It is a unique presentation of eosinophilic gastritis. To the best of our knowledge, no case of eosinophilic gastritis characterized by necrotic change such as necrotizing gastritis has been previously reported in Korea.

Warfarin-Induced Eosinophilic Pleural Effusion

A 29-year-old man suffering from dyspnea and eosinophilic pleural effusion after being on warfarin for pulmonary thromboembolism for a period of one month, was readmitted to our hospital. Etiology of pleural effusion other than warfarin was excluded. To the best of our knowledge, this is the first case of warfarin-induced pleural effusion reported in Korea.

Warfarin-Induced Eosinophilic Pleural Effusion

A 29-year-old man suffering from dyspnea and eosinophilic pleural effusion after being on warfarin for pulmonary thromboembolism for a period of one month, was readmitted to our hospital. Etiology of pleural effusion other than warfarin was excluded. To the best of our knowledge, this is the first case of warfarin-induced pleural effusion reported in Korea.

A Case of Rituximab Treatment for Interstitial Lung Disease in a Patient with Antisynthetase Syndrome / 대한류마티스학회지

The clinical manifestations of antisynthetase syndrome are severe interstitial pneumonitis, mild polyarthritis, and myositis. This disease is accompanied by anti-Jo-1 antibodies and anti-Ro/SSA antibodies and occasionally by the concurrence of anti-Jo-1 and anti-Ro/SSA antibodies, which leads to a more severe form of interstitial lung disease. In this case, the patient was transferred to our hospital because of pulmonary fibrosis with myositis and diagnosed with antisynthetase syndrome and the concurrence of anti-Jo-1 with anti-Ro/SSA antibodies. He was refractory to glucocorticoids, and developed leucopenia and thrombocytopenia. He was treated with rituximab infusions, but the interstitial pneumonitis progressed very rapidly and he died.

Prognostic Factors Affecting Survival Rate in Inflammatory Myositis / 대한류마티스학회지

OBJECTIVE: To assess the 10-year cumulative survival outcome of polymyositis (PM) and dermatomyositis (DM) as well as the factors associated with the the outcome. METHODS: Eighty five patients with PM and twenty one patients with DM were diagnosed at our university medical center between 1997 and 2007. Thirty six patients with PM and 13 patients with DM were followed up until death or until the end of January, 2008. Gender, age, AST, ALT, CPK, LDH, ESR, CRP, aldolase, drugs of therapy, combined ILD, and cancer, and duration of remission after therapy were assessed as prognostic factors of death by the Kaplan-Meier curve and Cox regression model. RESULTS: The respective 10-year survival rate for PM and DM was 80.8% (95% confidence interval (CI): 73.3~87.2) and 55.9% (95% CI: 40.7~71.1), respectively. The median survival for PM and DM was 11.3 years (95% CI: 9.8~12.9) and 7.0 years (95% CI: 3.6~10.5), respectively. Compared to DM patients, the subjects with PM had a 167.26 fold (95% CI: 7.59~3683.19) combined ILD adjusted risk of mortality (p<0.05) and no other individual factor reached significance as a predictor of death. However, cancer had a hazard ratio (HR) of 17.00 (95% CI: 1.06~281.79) and 2.45 (95% CI: 0.78~12.45) for death in the PM and DM group, respectively. CONCLUSION: According to an analysis of the survival and its prognostic factors in patients with PM and DM, ILD is a risk factor for mortality in PM and cancer was risk factor for mortality in both PM and DM.

A Case of Pneumomediastinum in the Course of Treatment in Lupus Myocarditis / 대한류마티스학회지

Systemic lupus erythematous (SLE) is systemic autoimmune disease of unknown etiology. SLE involve all part of heart but clinically important myocarditis is an unusual feature and is potentially fatal complication of SLE. We describe the woman who had diagnosed as SLE, 5 years ago and in that time, she had sinus tachycardia, mild dyspnea, chest discomfort, and depressed left ventricular function. She was diagnosed to myocarditis clinically and was treated by high-dose corticosteroids of intravenous pulse methylprednisolone. After treatment, she improved and showed improvement of left ventricular function. However, a sudden pneumomediastinum was occurred without trauma, and she died. The cause of pneumomediastinum was unexplained. We report a sudden pneumomediastinum in the course of lupus myocarditis presenting as sinus tachycardia with review of literature.

A Case of Maxillary Diffuse Large B Cell Lymphoma Induced to Headache in Behcet's Disease / 대한류마티스학회지

Behcet's disease is chronic and systemic inflammatory vasculitis, characterized by immunologically involving in variable size of arteries and veins. Clinically, principal manifestations are recurrent oral ulcer, genital ulcer, skin and eye lesions. Compared to other connective tissue disease, cancer is not accompanied commonly in Behcet's disease. But, immunological confusion such as T cell depletion or B cell hyperplasia, or long-term of immunosuppressive treatment lead to occurrence of malignancy. Recently, we experienced a case of maxillary mass, induced to abrupt headache in Behcet's disease, confirmed diffuse large B cell lymphoma by biopsy, and treated by rituximab-CHOP chemotherapy. Thus we report these with literature review.

A case report of descending necrotizing mediastinitis caused by odontogenic infection

A clinical study of frontal bone fracture