A Case of Hemolytic Uremic Syndrome associated with EB Virus Infection / 대한신장학회잡지

Hemolytic uremic syndrome (HUS) is characterized clinically by classic triad of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The illness is uncommon and various agents have been associated with HUS, such as infectious, genetic, environmental and phamacological factor. We experienced a case of hemolytic uremic syndrome in a eighty-year old man with a evidence for recent Epstein-barr virus infection. He developed hemolytic anemia, thrombocytopenia, hypertension and azotemia. His renal dysfunction was recovered by hemodialysis, plasmapheresis, warfarin and dypiridamole. We present this case with a review of the literature.

Common Mutation of Methylenetetrahydrofolate Reductass and Homocysteine in Patients with Coronary Artery Disease / 대한면역학회지

Recently the alanine/valine (A/V) polymorphism of the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene, one of the key enzymes catalyzing remethylation of homocysteine, has been reported to its association with coronary artery disease. lhe homozygous of C677T mutation (VV genotype) correlates with increased plasma homocysteine levels as a result of the reduced activity and increased thermolability of MTHFR. We investigated whether this rnutation and homocysteine influence risk for coronary artery disease (CAD) in normal control subjects and CAD patients and two risk groups, A (>2 risk factors) and B (<1 risk factor). The MTHFR genotype and plasma homocysteine were determined by PCR followed by HinA digestion and high performance liquid chromatography (HPLC) system, respectively. From this study, statistical significance of V mutation of MTHFR between four groups was not found. Homocysteine level was the highest in CAD patients and the lowest in risk group B. Plasma homocysteine level in VV genotype of CAD patients was significantly higher than in other two genotypes and normal control subjects. We concluded that homozygisty for the C677T mutation of MTHFR was not an independent risk factor of CAD but associated with a prediposition to increased plasma homocysteine levels in CAD patients.

A Case of Nocardial Peritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis / 대한신장학회잡지

Norcardia is an aerobic, gram-positive, AFB positive filamentous organism which is frequently branching. Nocardial infection is usually opportunistic and is found in immunosuppressed patients during transplantation or anti-cancer chemotherapy. With the increasing number of AIDS, nocardial infection have been increasingly recognized as a serious human infection. Among patients on peritoneal dialysis, Nocardia is a rare cause of peritonitis : only one case has been reported in Korea. It is extremely important to make an early and correct diagnosis and treatment with susceptible antibiotics. We report here a case of nocardial peritonitis associated with Continuous Ambulatory Peritoneal Dialysis(CAPD) which was resistant to trimethoprim/sulfamethoxazole and has treated successfully with imipenem and amikacin.