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1.
Article in English | WPRIM | ID: wpr-913833

ABSTRACT

Purpose@#Acute promyelocytic leukemia (APL) is a rare disease in children and there are some different characteristics between children and adult. We aimed to evaluate incidence, clinical characteristics and treatment outcomes of pediatric APL in Korea. @*Materials and Methods@#Seventy-nine pediatric APL patients diagnosed from January 2009 to December 2016 in 16 tertiary medical centers in Korea were reviewed retrospectively. @*Results@#Of 801 acute myeloid leukemia children, 79 (9.9%) were diagnosed with APL. The median age at diagnosis was 10.6 years (range, 1.3 to 18.0). Male and female ratio was 1:0.93. Thirty patients (38.0%) had white blood cell (WBC) count greater than 10×109/L at diagnosis. All patients received induction therapy consisting of all-trans retinoic acid and chemotherapy. Five patients (6.6%) died during induction chemotherapy and 66 patients (86.8%) achieved complete remission (CR) after induction chemotherapy. The causes of death were three intracranial hemorrhage, one cerebral infarction, and one sepsis. Five patients (7.1%) suffered a relapse during or after maintenance chemotherapy. The estimated 4-year event-free survival and overall survival (OS) rates were 82.1%±4.4%, 89.7%±5.1%, respectively. The 4-year OS was significantly higher in patients with initial WBC < 10×109/L than in those with initial WBC ≥ 10×109/L (p=0.020). @*Conclusion@#This study showed that the CR rates and survival outcomes in Korean pediatric APL patients were relatively good. The initial WBC count was the most important prognostic factor and most causes of death were related to serious bleeding in the early stage of treatment.

2.
Article in English | WPRIM | ID: wpr-914062

ABSTRACT

Haploidentical family donor hematopoietic stem cell transplantation (Haplo-HSCT) has been increasingly used for patients who require transplant for optimum therapy, but lack a human leukocyte antigen (HLA)-matched donor. Important variables that require consideration in choosing one of potentially many haplo-donors include evaluation for presence of donor-specific anti-HLA antibodies, the age and gender of the donor, the parental relationship of the donor especially for pediatric patients, and ABO compatibility. Three major platforms have been reported as valid methods of undertaking haplo-HSCT. Ex vivo T cell depleted transplant may allow for low rates of graft-versus-host disease, even without pharmacological prophylaxis after transplant. Major impediments such as delayed immune recovery and subsequent infections may be overcome by depletion of specific T cell subsets, as done in αβ T cell/B cell depleted transplants. Alternatively, T cell replete haplo-HSCT may be undertaken with post-transplantation cyclophosphamide, or by administering intensive pre- and post-transplant immunosuppression including use of anti-thymocyte globulin.All three haplo-HSCT platforms have been successfully used to treat children with hematologic malignancies. As this method of HSCT is relatively new, long-term follow-up is necessary to improve outcomes and clarify the toxicities of this transplant modality.

3.
Cancer Research and Treatment ; : 1184-1194, 2021.
Article in English | WPRIM | ID: wpr-913813

ABSTRACT

Purpose@#Effectiveness and safety of clofarabine (one of the treatment mainstays in pediatric patients with relapsed/refractory acute lymphoblastic leukemia [ALL]) was assessed in Korean pediatric patients with ALL to facilitate conditional coverage with evidence development. @*Materials and Methods@#In this multicenter, prospective, observational study, patients receiving clofarabine as mono/combination therapy were followed up every 4-6 weeks for 6 months or until hematopoietic stem cell transplantation (HSCT). Response rates, survival outcomes, and adverse events were assessed. @*Results@#Sixty patients (2-26 years old; 65% B-cell ALL, received prior ≥ 2 regimen, 68.3% refractory to previous regimen) were enrolled and treated with at least one dose of clofarabine; of whom 26 (43.3%) completed 6 months of follow-up after the last dose of clofarabine. Fifty-eight patients (96.7%) received clofarabine combination therapy. Overall remission rate (complete remission [CR] or CR without platelet recovery [CRp]) was 45.0% (27/60; 95% confidence interval [CI], 32.4 to 57.6) and the overall response rate (CR, CRp, or partial remission [PR]) was 46.7% (28/60; 95% CI, 34.0 to 59.3), with 11 (18.3%), 16 (26.7%), and one (1.7%) patients achieving CR, CRp, and PR, respectively. The median time to remission was 5.1 weeks (95% CI, 4.7 to 6.1). Median duration of remission was 16.6 weeks (range, 2.0 to 167.6 weeks). Sixteen patients (26.7%) proceeded to HSCT. There were 24 deaths; 14 due to treatment-emergent adverse events. @*Conclusion@#Remission with clofarabine was observed in approximately half of the study patients who had overall expected safety profile; however, there was no favorable long-term survival outcome in this study.

4.
Article in English | WPRIM | ID: wpr-897438

ABSTRACT

Purpose@#Recent cooperative trials in pediatric acute lymphoblastic leukemia (ALL) report long-term event-free survival (EFS) of greater than 80%. In this study, we analyzed the outcome and prognostic factors for patients with precursor B cell ALL (n=405) diagnosed during a 10-year period (2005-2015) at our institution. @*Materials and Methods@#All patients were treated with a uniform institutional regimen based on four risk groups, except for steroid type; patients diagnosed up till 2008 receiving dexamethasone, while subsequent patients received prednisolone. None of the patients received cranial irradiation in first complete remission. @*Results@#The 10-year EFS and overall survival was 76.3%±2.3% and 85.1%±1.9%. Ten-year cumulative incidence of relapse, any central nervous system (CNS) relapse and isolated CNS relapse was 20.8%±2.2%, 3.7%±1.1% and 2.5%±0.9% respectively. A comparison of established, good prognosis genetic abnormalities showed that patients with high hyperdiploidy had significantly better EFS than those with ETV6-RUNX1 rearrangement (10-year EFS of 91.2%±3.0% vs. 79.5%±4.4%, p=0.033). For the overall cohort, male sex, infant ALL, initial CNS involvement, and Philadelphia chromosome (+) ALL were significant factors for lower EFS in multivariate study, while high hyperdiploidy conferred favorable outcome. For high and very high risk patients (n=231), high hyperdiploidy was the only significant factor for EFS in multivariate study. @*Conclusion@#Regarding good prognosis genetic abnormalities, patients with high hyperdiploidy had significantly better outcome than ETV6-RUNX1 (+) patients. High hyperdiploidy was a major, favorable prognostic factor in the overall patient group, as well as the subgroup of patients with higher risk.

5.
Article in English | WPRIM | ID: wpr-889734

ABSTRACT

Purpose@#Recent cooperative trials in pediatric acute lymphoblastic leukemia (ALL) report long-term event-free survival (EFS) of greater than 80%. In this study, we analyzed the outcome and prognostic factors for patients with precursor B cell ALL (n=405) diagnosed during a 10-year period (2005-2015) at our institution. @*Materials and Methods@#All patients were treated with a uniform institutional regimen based on four risk groups, except for steroid type; patients diagnosed up till 2008 receiving dexamethasone, while subsequent patients received prednisolone. None of the patients received cranial irradiation in first complete remission. @*Results@#The 10-year EFS and overall survival was 76.3%±2.3% and 85.1%±1.9%. Ten-year cumulative incidence of relapse, any central nervous system (CNS) relapse and isolated CNS relapse was 20.8%±2.2%, 3.7%±1.1% and 2.5%±0.9% respectively. A comparison of established, good prognosis genetic abnormalities showed that patients with high hyperdiploidy had significantly better EFS than those with ETV6-RUNX1 rearrangement (10-year EFS of 91.2%±3.0% vs. 79.5%±4.4%, p=0.033). For the overall cohort, male sex, infant ALL, initial CNS involvement, and Philadelphia chromosome (+) ALL were significant factors for lower EFS in multivariate study, while high hyperdiploidy conferred favorable outcome. For high and very high risk patients (n=231), high hyperdiploidy was the only significant factor for EFS in multivariate study. @*Conclusion@#Regarding good prognosis genetic abnormalities, patients with high hyperdiploidy had significantly better outcome than ETV6-RUNX1 (+) patients. High hyperdiploidy was a major, favorable prognostic factor in the overall patient group, as well as the subgroup of patients with higher risk.

6.
Article | WPRIM | ID: wpr-835534

ABSTRACT

This document is the third part of the guidelines for the interpretation and post-processing of cardiac magnetic resonance (CMR) studies. These consensus recommendations have been developed by a Consensus Committee of the Korean Society of Cardiovascular Imaging (KOSCI) to standardize the requirements for image interpretation and post-processing of CMR. This third part of the recommendations describes tissue characterization modules, including perfusion, late gadolinium enhancement, and T1- and T2 mapping. Additionally, this document provides guidance for visual and quantitative assessment, consisting of “What-to-See,” “How-To,” and common pitfalls for the analysis of each module. The Consensus Committee hopes that this document will contribute to the standardization of image interpretation and post-processing of CMR studies.

7.
Article in English | WPRIM | ID: wpr-831569

ABSTRACT

Background@#Hodgkin's lymphoma (HL) constitutes 10%–20% of all malignant lymphomas and has a high cure rate (5-year survival, around 90%). Recently, interest has increased concerning preventing secondary complications (secondary cancer, endocrine disorders) in long-term survivors. We aimed to study the epidemiologic features and therapeutic outcomes of HL in children, adolescents, and young adults in Korea. @*Methods@#We performed a multicenter, retrospective study of 224 patients aged < 25 years diagnosed with HL at 22 participating institutes in Korea from January 2007 to August 2016. @*Results@#A higher percentage of males was diagnosed at a younger age. Nodular sclerosis histopathological HL subtype was most common, followed by mixed cellularity subtype.Eighty-one (36.2%), 101 (45.1%), and 42 (18.8%) patients were classified into low, intermediate, and high-risk groups, respectively. Doxorubicin, bleomycin, vinblastine, dacarbazine was the most common protocol (n = 102, 45.5%). Event-free survival rate was 86.0% ± 2.4%, while five-year overall survival (OS) rate was 96.1% ± 1.4%: 98.7% ± 1.3%, 97.7% ± 1.6%, and 86.5% ± 5.6% in the low, intermediate, and high-risk groups, respectively (P = 0.021). Five-year OS was worse in patients with B-symptoms, stage IV disease, highrisk, splenic involvement, extra-nodal lymphoma, and elevated lactate dehydrogenase level.In multivariate analysis, B-symptoms and extra-nodal involvement were prognostic factors for poor OS. Late complications of endocrine disorders and secondary malignancy were observed in 17 and 6 patients, respectively. @*Conclusion@#This is the first study on the epidemiology and treatment outcomes of HL in children, adolescents, and young adults in Korea. Future prospective studies are indicated to develop therapies that minimize treatment toxicity while maximizing cure rates in children, adolescents, and young adults with HL.

8.
Blood Research ; : S27-S31, 2020.
Article | WPRIM | ID: wpr-830984

ABSTRACT

Adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) have worse prognosis than children. Differing biology of ALL may account for some of this disparity in outcome, with AYA patients having far lower incidence of good risk cytogenetic abnormalities, and higher proportion of patients with genetic lesions associated with inferior survival such as Ph-like ALL. Actual chemotherapy may also contribute to differences in outcome. Retrospective studies have shown that AYA patients treated on pediatric-based regimens had higher survival than those treated with adult regimens; the superiority of pediatric protocols has also been proven in several prospective comparative trials. Increase in rate of enrollment of AYA patients in clinical trials may further improve outcome. Cure based on chemotherapy may further limit the role of allogeneic hematopoietic cell transplantation (HCT) in AYA patients. The unique biology of AYA ALL may allow for novel methods of targeted therapy, while immunotherapy, the efficacy of which has been proven for both children and adults, may also play a major role in the treatment of relapsed/refractory ALL.

9.
Article in English | WPRIM | ID: wpr-719418

ABSTRACT

PURPOSE: Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients. MATERIALS AND METHODS: Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected. RESULTS: Data of total 1,453 cases were analyzed; dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups; however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%; D, 0.60%±0.28%; p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis. CONCLUSION: Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration.


Subject(s)
Anthracyclines , Cardiotoxicity , Dexrazoxane , Disease-Free Survival , Follow-Up Studies , Humans , Incidence , Korea , Multivariate Analysis , Neoplasms, Second Primary , Risk Factors , Stem Cell Transplantation
10.
Infection and Chemotherapy ; : 183-187, 2019.
Article in English | WPRIM | ID: wpr-914574

ABSTRACT

This retrospective study was performed to determine the seroprevalence of hepatitis A virus (HAV) in children and adolescents with hematologic malignancies after the completion of chemotherapy and hematopoietic cell transplantation (HCT). Of 97 enrolled patients, 60 (61.9%) were seropositive for HAV. The seroprevalences in patients undergoing chemotherapy and HCT were 60.3% (41/68) and 65.5% (19/29), respectively (P = 0.628). No significant factors associated with seropositivity for HAV after chemotherapy and HCT were identified. Anti-HAV tests and HAV re-vaccinations can be considered in children and adolescents with underlying hematologic malignancies after chemotherapy and HCT based on the anti-HAV results.

11.
Blood Research ; : 45-51, 2019.
Article in English | WPRIM | ID: wpr-739435

ABSTRACT

BACKGROUND: Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) is a subset of ALL with poor prognosis. Here, we analyzed the outcomes and prognostic factors of children with Ph+ ALL who received imatinib and chemotherapy followed by allogeneic hematopoietic cell transplantation (HCT) in first complete remission (CR). METHODS: Thirty-one Ph+ ALL patients (female 10) diagnosed from January 2005 to December 2016 were included in the study. All patients were treated with imatinib and chemotherapy before HCT. Bone marrow (BM) evaluations included real-time quantitative polymerase chain reaction (RQ-PCR) study of the BCR-ABL1 fusion transcript. All patients received HCT with total body irradiation (TBI)-based conditioning at a median of 6.4 (range, 4.2–47.1) months from diagnosis. RESULTS: Compared to values at diagnosis, the median decrement of RQ-PCR value post-consolidation, and prior to HCT was −3.7 Log and −4.8 Log, respectively. The 5-year event-free survival (EFS) and overall survival of the patients were 64.5±9.4% (20/31) and 75.0±8.3% (23/31) respectively. Events included relapse (N=5) and death in CR post-HCT (N=6). The 5-year incidence of molecular relapse was 30.9±9.1% (9/31). An RQ-PCR decrement of at least −4 Log post-consolidation significantly predicted lower incidence of molecular relapse: 7.7±7.7% for ≥−4 Log decrement, 50.0±13.8% for <−4 Log decrement (P=0.027). CONCLUSION: Decrement in RQ-PCR for the BCR-ABL1 transcript that was determined after consolidation was the only significant prognostic factor for incidence of molecular relapse. In the post-induction TKI initiation setting, steadfast imatinib treatment during consolidation may allow for optimum post-HCT outcomes.


Subject(s)
Bone Marrow , Cell Transplantation , Child , Diagnosis , Disease-Free Survival , Drug Therapy , Humans , Imatinib Mesylate , Incidence , Philadelphia Chromosome , Polymerase Chain Reaction , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Prognosis , Recurrence , Transplants , Whole-Body Irradiation
12.
Article in English | WPRIM | ID: wpr-739121

ABSTRACT

We reviewed our leukemia database to reclassify 610 patients previously diagnosed as having acute myeloid leukemia (AML) according to the updated 2016 WHO classification. Nine patients were categorized as having myelodysplastic syndrome and myeloid neoplasms with germline predisposition. AML with recurrent genetic abnormalities accounted for 57.4% (345/601) of the patients under the 2016 WHO classification. AML with mutated NPM1 was the most common form (16.5%), with the majority associated with monocytic differentiation (63.6%). AML with double CEBPA mutations accounted for 8.3% of these cases, and the majority were previously diagnosed as AML with/without maturation (78.0%). These newly classified mutations were mutually exclusive without overlapping with other forms of AML with recurrent genetic abnormalities. AML with mutated NPM1 and AML with myelodysplasia-related changes comprised the oldest patients, whereas AML with RUNX1-RUNX1T1 included the youngest patients. The leukocyte count was highest in AML with mutated NPM1, and the percentage of peripheral blood blasts was the highest in AML with double CEBPA mutations. Our results indicate that implementation of the 2016 WHO classification of AML would not pose major difficulties in clinical practice. Hematopathologists should review and prepare genetic tests for the new classification, according to their clinical laboratory conditions.


Subject(s)
Classification , Humans , Leukemia , Leukemia, Myeloid, Acute , Leukocyte Count , Myelodysplastic Syndromes
13.
Korean Journal of Radiology ; : 1562-1582, 2019.
Article in English | WPRIM | ID: wpr-786373

ABSTRACT

This document is the third part of the guidelines for the protocol, the interpretation and post-processing of cardiac magnetic resonance (CMR) studies. These consensus recommendations have been developed by the Consensus Committee of the Korean Society of Cardiovascular Imaging to standardize the requirements for image interpretation and post-processing of CMR. This third part of the recommendations describes tissue characterization modules, including perfusion, late gadolinium enhancement, and T1- and T2 mapping. Additionally, this document provides guidance for visual and quantitative assessment consisting of “What-to-See,” “How-To,” and common pitfalls for the analysis of each module. The Consensus Committee hopes that this document will contribute to the standardization of image interpretation and post-processing of CMR studies.


Subject(s)
Consensus , Gadolinium , Hope , Magnetic Resonance Imaging , Perfusion
14.
Article in English | WPRIM | ID: wpr-785884

ABSTRACT

Cardiac magnetic resonance (CMR) imaging is widely used in many areas of cardiovascular disease assessment. This is a practical, standard CMR protocol for beginners that is designed to be easy to follow and implement. This protocol guideline is based on previously reported CMR guidelines and includes sequence terminology used by vendors, essential MR physics, imaging planes, field strength considerations, MRI-conditional devices, drugs for stress tests, various CMR modules, and disease/symptom-based protocols based on a survey of cardiologists and various appropriate-use criteria. It will be of considerable help in planning and implementing tests. In addressing CMR usage and creating this protocol guideline, we particularly tried to include useful tips to overcome various practical issues and improve CMR imaging. We hope that this document will continue to standardize and simplify a patient-based approach to clinical CMR and contribute to the promotion of public health.


Subject(s)
Cardiovascular Diseases , Commerce , Exercise Test , Heart , Hope , Magnetic Resonance Imaging , Public Health
15.
Article in English | WPRIM | ID: wpr-785883

ABSTRACT

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technology advances and the expanded national insurance coverage of these tests. For improved patient care, it is crucial not only that CMR images are properly acquired but that they are accurately interpreted by well-trained personnel. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology (KSR). KOSCI has also created a formal Committee on CMR Guidelines to write updated practices. The members of this Committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.


Subject(s)
Angiography , Heart , Insurance Coverage , Korea , Magnetic Resonance Imaging , Patient Care
16.
Korean Journal of Radiology ; : 1313-1333, 2019.
Article in English | WPRIM | ID: wpr-760306

ABSTRACT

Cardiac magnetic resonance (CMR) imaging is widely used in many areas of cardiovascular disease assessment. This is a practical, standard CMR protocol for beginners that is designed to be easy to follow and implement. This protocol guideline is based on previously reported CMR guidelines and includes sequence terminology used by vendors, essential MR physics, imaging planes, field strength considerations, MRI-conditional devices, drugs for stress tests, various CMR modules, and disease/symptom-based protocols based on a survey of cardiologists and various appropriate-use criteria. It will be of considerable help in planning and implementing tests. In addressing CMR usage and creating this protocol guideline, we particularly tried to include useful tips to overcome various practical issues and improve CMR imaging. We hope that this document will continue to standardize and simplify a patient-based approach to clinical CMR and contribute to the promotion of public health.


Subject(s)
Cardiovascular Diseases , Commerce , Exercise Test , Heart , Hope , Magnetic Resonance Imaging , Public Health
17.
Korean Journal of Radiology ; : 1477-1490, 2019.
Article in English | WPRIM | ID: wpr-760261

ABSTRACT

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technological advances and the expanded national insurance coverage of CMR assessments. For improved patient care, proper acquisition of CMR images as well as their accurate interpretation by well-trained personnel are equally important. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology. KOSCI has also created a formal Committee on CMR guidelines to create updated practices. The members of this committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.


Subject(s)
Angiography , Heart , Insurance Coverage , Korea , Magnetic Resonance Imaging , Patient Care
18.
Article in Korean | WPRIM | ID: wpr-770035

ABSTRACT

As the population grows older and medical treatments are advancing, the number of spine surgeries in elderly patients has been increasing. To obtain a successful outcomes of spine surgery in elderly patients, surgeons should prepare meticulously because elderly patients can have osteoporosis and surgery can be more extensive than in younger patients. Therefore, this study reviewed the perioperative medical treatment, particularly for osteoporosis, to improve the surgical outcomes in elderly patients.


Subject(s)
Aged , Humans , Osteoporosis , Spine , Surgeons
19.
Article in Korean | WPRIM | ID: wpr-918795

ABSTRACT

Pulmonary thromboembolism frequently occurs in patients with deep vein thrombosis, but in patients with right-sided endocarditis, it can sometimes occur due to embolization of vegetation. We experienced pulmonary thromboembolism and pulmonary infarction in a patient with tricuspid valve endocarditis with the ventricular septal defect. Echocardiography and cardiac computed tomography revealed ventricular septal defect and tricuspid valve vegetation. Chest computed tomography showed pulmonary thromboembolism and pulmonary infarction in the affected segments. The patient underwent ventricular septal defect patch closure and tricuspid valve replacement and improved after antibiotics and anticoagulant treatment.

20.
Article in English | WPRIM | ID: wpr-717186

ABSTRACT

BACKGROUND/AIMS: The true incidence of aristolochic acid nephropathy (AAN) is thought to be underestimated because numerous ingredients known or suspected to contain aristolochic acid (AA) are used in traditional medicine in Korea. METHODS: We collected data on cases of AAN since 1996 via a database in Korea. We evaluated the year of AAN development, route to obtaining AA-containing herbal medicine, gender, reason for taking AA-containing herbal medicine, clinical manifestations, histological findings, phytochemical analysis, and prognosis of patients with AAN. RESULTS: Data on 16 cases of AAN were collected. Thirteen cases developed AAN before and three cases after the prohibition of AA-containing herbal medicine by the Korea Food and Drug Administration. Patients were prescribed AA-containing herbal medicine from oriental clinics or had purchased it from traditional markets. AAN was distributed in all age groups. Young females were most commonly exposed to AA-containing herbal medicine for slimming purposes and postpartum health promotion, while older adults took AA-containing compounds for the treatment of chronic diseases. The most common symptoms presented at hospitalization were nausea and vomiting, and acute kidney injury was accompanied by Fanconi syndrome in almost half of the patients. Phytochemical analysis of AA in herbal medicine was available in six cases. Progression to end stage renal disease (ESRD) was observed in seven patients (43.8%), and five patients (31.3%) had progressed to ESRD within 6 months of diagnosis. CONCLUSIONS: Our report shows that patients were still exposed to AA-containing herbal medicine and that there is a possibility of underdiagnosis of AAN in Korea. A stronger national supervision system of herbal ingredients and remedies in oriental medicine is needed to prevent AAN.


Subject(s)
Acute Kidney Injury , Adult , Chronic Disease , Diagnosis , Fanconi Syndrome , Female , Health Promotion , Herbal Medicine , Hospitalization , Humans , Incidence , Kidney Failure, Chronic , Korea , Medicine, East Asian Traditional , Medicine, Traditional , Nausea , Organization and Administration , Postpartum Period , Prognosis , United States Food and Drug Administration , Vomiting
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