A Case of Spontaneous Hemoperitoneum Presenting as the Initial Manifestation of Systemic Lupus Erythematosus

Thrombocytopenia is included in the classification criteria for systemic lupus erythematosus (SLE). However, severe thrombocytopenia causing spontaneous bleeding is rare. Here, we describe a 22-year-old woman who presented with spontaneous hemoperitoneum as the first manifestation of SLE. Laboratory findings compatible with SLE included positive antinuclear antibody and a false-positive venereal disease research laboratory. Symptoms suggesting the disease were not prominent early after admission, but headache and seizures that developed on the 3rd day of admission led to the diagnosis of SLE. The brain magnetic resonance imaging and angiography findings were compatible with the neuropsychiatric manifestations of SLE. High-dose steroid and monthly intravenous cyclophosphamide pulse therapy were effective at improving the headache and seizure, as well as the hemoperitoneum.

Diffuse Idiopathic Skeletal Hyperostosis with Syndesmophytes on the Iliac Spine / 대한류마티스학회지

No abstract available.

Multicenter Study in Efficacy and Safety of Celecoxib in Patients with Rheumatoid Arthritis and Osteoarthritis / 대한류마티스학회지

OBJECTIVE: The aim of this study was to define the efficacy and safety of celecoxib in Korean patients with rheumatoid arthritis and osteoarthritis. In addition, the impact of gastrointestinal symptom severity on health related quality of life (HRQoL) was measured before and after the treatment with celecoxib. METHODS: Three hundred seventy nine patients with rheumatoid arthritis (n=175) and osteoarthritis (n=204) were enrolled from 25 centers from May 2004 to December 2004. After treatment of celecoxib for 4 weeks, efficacy was determined by physician's global assessment and EQ-5D. Severity of gastrointestinal (GI) symptom was assessed by visual analogue scale. RESULTS: Treatment made improvement in 263 patients (69.4%), but 108 patients (28.5%) didn't show change in their symptom and 8 patients (2.1%) were aggravated after treatment. Mean change was 0.129+/-0.3 in EQ-5D utility score (p<0.05), 11.8+/-17.8 in VAS in EQ-5D (p<0.05) and -7.9+/-19.6 in GI symptom severity (p<0.05). Blood pressure was not elevated after treatment and there was no cardiovascular adverse event. Gastrointestinal symptom improvement correlates with improvement in VAS (r=0.2, p<0.01). CONCLUSION: Celecoxib is not only effective in patients with rheumatoid arthritis and osteoarthritis but also helpful in reducing GI symptom.

Incidence of Gallbladder Stones in Renal Transplant Recipients / 대한소화기학회지

BACKGROUND/AIMS: Gallbladder stone is one of the major cause of morbidity in adults. Renal transplantation has been found to increase the risk of gallbladder stone formation. The real incidence of gallbladder stones in renal transplant recipients is not exactly known. We performed this study to identify the risk factors for cholecystolithiasis. METHODS: We compared the prevalence of gallbladder stone in 222 renal transplantation patients with that in 222 age and sex matched controls. Patients who had chronic liver disease, renal disease, and diabetes were excluded from the control group. RESULTS: In our study, the incidence of gallbladder stones is 8.6% (19/222 patients) in renal transplantation patients, which was significantly higher than 3.60% (8/222 control) in the control group (p=0.029). In the most of our renal transplantation patients, cholecystolithiasis was asymptomatic. We did not find a difference in age, sex, duration after transplantation, causes of renal failure, resistance index between patients with and without gallbladder stones in renal transplantation patients. CONCLUSIONS: Our results suggest that the incidence of gallbladder stones is higher in renal transplant recipients than non-transplant population in Korea. Further studies will be needed to focus the factors contributing to the gallbladder stone formation after renal transplantation, especially in regard to immunosuppressive drugs.

Catalase and PPAR-gamma Polymorphisms of Rheumatoid Arthritis in Korean / 대한류마티스학회지

OBJECTIVE: To investigate the association between a single nucleotide polymorphism in the catalase and peroxisome proliferator activated receptor- gamma (PPAR-gamma) genes with risk and severity of rheumatoid arthritis (RA) in Korea. METHODS: DNA was isolated from blood samples collected from 473 Korean patients with RA and 400 Korean controls. Genotyping for the C-262T polymorphism of catalase and the Pro12Ala polymorphism of PPAR-gamma was performed by PCR-RFLP (restriction fragment length polymorphism) analysis. Subjects were classified according to ACR criteria for RA, KHAQ, and radiological severity classification by Steinbroker. RESULTS: In patient group, catalase C/T and T/T polymorphism was seen in 23 (4.9%) and 0 patients while Pro/Ala and Ala/Ala PPAR-gamma polymorphism was seen in 42 (8.9%) and 1 (0.2%) patients. In control group, catalase C/T and T/T polymorphism was seen in 25 (6.3%) and 1 (0.2%) controls while Pro/Ala and Ala/Ala PPAR-gamma polymorphism was seen in 34 (8.5%) and 4 (1%) controls. Catalase and PPAR-gamma polymorphism showed no association with the susceptibility to RA individually but, when combined association was found although it had no statistical significance, which was possibly due to its low frequency. Catalase and HLA-DRB1 polymorphism showed significant interaction on development of RA but, no interaction was found between PPAR-gamma and HLA-DRB1. Catalase and PPAR-gamma polymorphism showed no association with the severity or functional status of RA. CONCLUSION: Our results show that genetic polymorphisms of catalase and PPAR-gamma has no association with the susceptibility to RA. Catalase and HLA-DRB1 polymorphism showed significant interaction on development of RA.

Health-Related Quality of Life using EQ-5D in Koreans / 대한류마티스학회지

OBJECTIVE: There has been no data on health related quality of life (HRQOL) in general Korean population. Assessing factors affecting HRQOL in Koreans is fundamental in HRQOL research. The objective of this study is to assess HRQOL in Korean using Korean version of EQ-5D (KEQ-5D). METHODS: HRQOL was assessed using KEQ-5D from 1,044 randomly selected population representing general Korean population with telephone interview RESULT: The mean KEQ-5D utility score in Korean was 0.88 (range: -0.59~1.00). Sociodemographic data showed relatively higher score in male, younger, well educated, higher income, and white color people. Among a variety of diseases, gastric ulcer/gastritis, arthritis, hypertension diabetes, low back pain were common in Korea. The most significant chronic diseases influencing Koreans were gastrointestinal disorder and arthritis. CONCLUSION: This paper suggests basic information on HRQOL in Korean and can be a useful parameter in comparison in the future research.

A case of bilateral psoas abscess in multiple myeloma patient / 대한내과학회지

Psoas abscess is caused by primary or secondary and most commonly results from direct extension of intraabdominal infections. Staphylococcus aureus is the most common organism for psoas abscess secondary to vertebral osteomyelitis. Tuberculosis, malnutrition, alcoholism, diabetes mellitus, bone marrow failure, and steroid use are responsible for compromise in host defense and consequent increase in the relative risk of psoas abscess. We report here a case of bilateral poas abscess developed in a 58 year old patient with relapsed plasmacytoma in pelvic cavity during chemotherapy.