Diffuse Alveolar Hemorrhage after Adalimumab Treatment of Rheumatoid Arthritis / 대한내과학회지

Diffuse alveolar hemorrhage (DAH) is a life-threatening condition involving hemorrhage originating in the pulmonary microvasculature. The clinical syndrome is characterized by hemoptysis, hypoxemic respiratory failure, low-grade fever, and diffuse pulmonary infiltrates. The majority of cases of DAH are caused by pulmonary renal syndromes, connective tissue disorders, and drugs. Here, we present a case of DAH associated with adalimumab treatment in a patient with rheumatoid arthritis.

A Case of Adult Onset Still's Disease Presented with Acute Febrile Hepatitis / 대한내과학회지

Adult-onset Still's Disease (AOSD) is a rare, immune-mediated, multisystem inflammatory disorder characterized by quotidian spiking fevers, an evanescent rash, arthritis, lymphadenopathy, splenomegaly, a sore throat, leukocytosis, and liver dysfunction. Its clinical manifestations are very diverse, from relatively mild symptoms to severe complications, such as disseminated intravascular coagulation, cardiac tamponade, acute respiratory distress syndrome, hemophagocytic syndrome, and hepatic failure. Hepatic failure is an extremely rare complication that could lead to death. Therefore, early diagnosis and treatment are important. We report a case of adult-onset Still's disease with acute febrile hepatitis.

A case of peripheral T-cell lymphoma presenting with a necrotizing gingival ulcer / 대한내과학회지

Peripheral T-cell lymphoma (PTCL) is a heterogenous group of generally aggressive neoplasms constituting less than 15% of all non-Hodgkin's lymphomas in adults. PTCL unspecified (PTCL-U) comprises 6% of lymphomas in the United States and Europe. Most patients with PTCL-U present with generalized lymphadenopathy and hemophagocytosis, eosinophilia, and pruritus involving the skin, liver, spleen, and other viscera. Gingival and genital ulcers are a very uncommon manifestation. The diagnosis of PTCL-U is based on the results of a tissue biopsy that shows evidence of T-cell lymphoma that does not meet the criteria for other subtypes of T-cell lymphoma. Here, we describe an 85-year-old man with intermittent fever and necrotizing gingival and genital ulcers who was diagnosed with PTCL-U after a gingival biopsy.

Breast tuberculosis mimicking breast abscess in a healthy woman / 대한내과학회지

Breast tuberculosis is a rare form of tuberculosis (TB). In healthy individuals in developed countries, the incidence is <0.1% of breast lesions examined histologically. The significance of breast TB is due to its rare occurrence and mistaken identity with breast cancer or pyogenic breast abscess. We report the case of an 18-year-old healthy woman diagnosed with breast TB that mimicked breast abscess. She was admitted for multiple erythema nodosum (EN) of the lower extremities of 6 weeks duration. She also noticed a painful oral ulcer and a palpable nodule with fistula on the right breast for 8 weeks. Our patient had the characteristic radiological and histopathological features of breast TB. Breast abscess and EN improved after antitubercular medication, including isoniazid, rifampin, ethambutol and pyrazinamide.