A Case of Secondary Amyloid Colitis in Rheumatoid Arthritis

Amyloidosis is known as a disease caused by the deposition of a insoluble and fibrous amyloid protein in the extracellular space of various organs and tissue. Intestinal amyloid deposition may develop motility disturbance, malabsorption, bleeding and perforation. A 70-year old woman with lower abdominal pain, watery diarrhea was admitted and had the past history of diabetes mellitus, hypertension for 8 years and rheumatoid arthritis for 10 year. On colonoscopic examination for evaluation of diarrhea, multiple edematous and shallow ulcers was found from distal sigmoid to terminal ileum. A green colored positive birifringent stained amorphous material was found in polarizing microscopy of colon biopsy specimen stained with Congo-red on microscopic examination,. We report a case of amyloidosis causing colon ulcers confirmed by colonoscopic biopsy with review literature.

A Case of Boerhaave Syndrome with Empyema in both Lungs in Alcoholic Liver Cirrhosis / 대한소화기내시경학회지

Spontaneous esophageal perforation (Boerhaave Syndrome) is an unusual condition that frequently leads to fatal complications. It typically occurs with rigorous emesis after an unduly large meal or heavy drinking. Its diagnosis is often delayed in almost all cases due to nonspecific symptoms and signs, resulting in increased morbidity and mortality. Therefore early diagnosis and appropriate treatment are very important. Recently we experienced a case of esophagogastric junctional perforation accompanied by bilateral empyema and mediastinitis after heavy alcohol drinking in a 56-year-old male patient. He was presented with hematemesis and abdominal pain. We diagnosed him using esophagography and chest CT. Thus, we report a case with a brief review of related literatures.

A Case of Furosemide Induced Acute Interstitial Nephritis / 대한신장학회잡지

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.