A Case of Rhabdomyolysis and Acute Renal Failure Associated with Mitochondrial Myopathy / 대한신장학회잡지

Mitochondrial myopathies are diseases caused by defects in metabolic pathway of mitochondria. Mitochondrial myopathy is known as one of the causes of recurrent myoglobinuria, while clinically, rarely causes acute renal failure requiring medical treatments. We report a case of rhabdomyolysis and acute renal failure associated with mitochondrial myopathy. A 58-year-old male was presented with dyspnea and hypotensive shock. The patient had a history of recurrent dark colored urine and cramping leg pain after prolonged fasting. Laboratory findings showed hyperkalemia, azotemia, metabolic acidosis, and elevated AST, ALT, and creatinine kinase. He had no history of trauma or medication. Muscle biopsy showed "ragged red fibers" in modified Gomori staining. On electron microscope, increased number of mitochondria and abnormal mitochondria were seen. He received hemodialysis and his renal function recovered after 1 month.

A review of lead poisoning cases reported for recent 30 years in Korea / 대한내과학회지

BACKGROUND: Because of widespread and long-term use of lead, many lead poisoning cases were reported. Especially, in Korea including Southeast Asia, we observed non-occupational lead poisoning cases by herbal medication. METHODS: We identified total 45 cases of lead poisoning through Medric search, from 1973 to 2002. Bibliographies of relevant articles were reviewed. We arranged cases by attributes following 1) reported year, 2) age, 3) sex, 4) exposure sources, 5) exposure duration, 6) clinical manifestation, 7) treatments. RESULTS: The average age of the patients was 41.4 +/- 15.7 year-old. The distribution by sex did not have difference each other. The non-occupational lead poisoning cases were mostly caused by Chinese herbal medication. On the cases of the herbal lead poisoning, average exposure duration was 7.3 +/- 3.8 months and the various dosages were taken from 5 mg to 3 g. The major clinical symptoms were abdominal pain, headache, and constipation. The typical laboratory finding was anemia. Major treatment agent was oral penicillamine. CONCLUSION: To differential diagnose of the lead poisoning from many diseases with similar symptoms is very difficult solely on the clinical aspect. Especially, in non-occupational cases it is more difficult. In Korea, non-occupational lead poisoning cases by herbal medication have been discovered more than in western countries. We reviewed about the lead poisoning cases since 1973, so we want to make an aware of scientific and rational making and management of lead in the health supplementary food and herbal medicine.

A case of acute respiratory distress syndrome (ARDS) due to endobronchial tubercubsis / 대한내과학회지

Endobronchial tuberculosis is defined as a specific inflammation of the trachea or major bronchi caused by the tubercle bacillus. It is recognized as one of the most common and serious complication of pulmonary tuberculosis. A diagnosis of endobronchial tuberculosis is difficult due to the diversity of radiological patterns. But, it is still relatively common disease in korea. Endobronchial tuberculosis as a cause of the acute respiratory distress syndrome (ARDS) is quite rare. The mortality rate of ARDS is still high in korea. The detection and early elimination of the causes for ARDS at the initial stage can result in a more favorable prognosis. So, patients with ARDS, especially due to endobronchial tuberculosis or other form of tuberculosis, should be treated with antituberculous drugs as soon as possible. We experienced a young female with complaints of sudden onset dyspnea, mild fever. In this case the clinical features, laboratory data and radiologic findings allowed an initial presentation of ARDS. The ARDS was defined by the American-Europian Consensus Conference 19921-3). The cause of ARDS was revealed endobronchial tuberculosis. We started antituberculosis medication and steroid injection quickly, which resulted in good prognosis. We emphasize the prognosis depends mainly on the early recognition and treatment of endobronchial tuberculosis.

A Case of Dengue Shock Syndrome Imported from Myanmar / 감염과화학요법

Dengue fever/dengue shock syndrome is an acute febrile illness caused by a Flaviviridae virus. Dengue virus infection can cause a wide spectrum of illness, and disease is characterized by sudden onset of high fever, chill, severe headache, skin rash, general malaise and thrombocytopenia with hemoconcentration. Dengue fever is endemic in most tropical areas of world, including the Caribbean, Central and South America, Africa, and Southeast Asia. Tourists to these areas are liable to infection. We experienced a Korean female who returned to Korea from Myanmar in severely ill state. She was confirmed serologically to be inblieted with Dengue shock syndrome. In spite of intensive medical care, she died of Dengue shock syndrome. We emphasize that favorable prognosis depends mainly on the early recognition and treatment of shock.

A Case of Dengue Shock Syndrome Imported from Myanmar / 감염과화학요법

Dengue fever/dengue shock syndrome is an acute febrile illness caused by a Flaviviridae virus. Dengue virus infection can cause a wide spectrum of illness, and disease is characterized by sudden onset of high fever, chill, severe headache, skin rash, general malaise and thrombocytopenia with hemoconcentration. Dengue fever is endemic in most tropical areas of world, including the Caribbean, Central and South America, Africa, and Southeast Asia. Tourists to these areas are liable to infection. We experienced a Korean female who returned to Korea from Myanmar in severely ill state. She was confirmed serologically to be inblieted with Dengue shock syndrome. In spite of intensive medical care, she died of Dengue shock syndrome. We emphasize that favorable prognosis depends mainly on the early recognition and treatment of shock.