Acute pulmonary manifestation in ulcerative colitis / 대한내과학회지

The ulcerative colitis is a chronic inflammatory bowel disease of unknown etiology. The major symptoms of ulcerative colitis are diarrhea, hematochezia, tenesmus, and abdominal pain. However, occasionally the arthritis, skin disorders, hepatobiliary inflammation, and uveitis are recognized systemic complications or extracolonic manifestations of ulcerative colitis. Though there have been rare reports of coexistent pulmonary and inflammatory bowel disease, the lung is not generally considered a target organ in ulcerative colitis. Since the first observation of pulmonary involvement in ulcerative colitis by Kraft in 1976, a few cases have been reported. We describe of a patient with ulcerative colitis and extracolonic manifestations in whom pulmonary involvement developed that was responsive to corticosteroid therapy.

A Case of Pyoderma Gangrenosum Complicating Crohn's Disease / 대한소화기내시경학회지

Pyoderma gangrenosum is a rare chronic cutaneous disease with distinctive clinical characteristics. A painful nodule or pustule breaks down to form a progressively enlarging ulcer. The diagnosis is confirmed by exclusion of other diseases that may cause cutaneous ulcers. Associated conditions are common. The most common associated conditions are inflammatory bowel diseases, arthritis, hematologic disorders. Pyoderma gangrenosum develops in approximately 3~5% of patients with ulcerative colitis and 1% of patients with Crohn's disease. Until now, only one case of pyoderma gangrenosum associated with Crohn's disease has been reported in Korea. Recently, we experienced a case of pyoderma gangrenosum developed in a patient with Crohn's disease.

A Case of Pseudo-obstruction Responding to Neostigmine / 대한소화관운동학회지

Pseudo-obstruction is a clinical syndrome caused by ineffective intestinal propulsion and characterized by symptoms and signs of intestinal obstruction in the absence of an occluding lesion of the intestinal lumen. A 65-year-old male who complained of abdominal pain and obspitation. (not constipation?) was admitted. Simple abdominal radiographs revealed marked colonic dilatation without mechanical obstruction suggesting pseudo-obstruction. Clinical response with conservative care failed to improve the patient. 2.0 mg of neostigmine which was recently reported to be an effective way to decompress the colon in patients with acute colonic pseudo-obstruction, was administered. Immediate clinical response was achieved without complication.

A Case of Pseudo-obstruction Responding to Neostigmine / 대한소화관운동학회지

Pseudo-obstruction is a clinical syndrome caused by ineffective intestinal propulsion and characterized by symptoms and signs of intestinal obstruction in the absence of an occluding lesion of the intestinal lumen. A 65-year-old male who complained of abdominal pain and obspitation. (not constipation?) was admitted. Simple abdominal radiographs revealed marked colonic dilatation without mechanical obstruction suggesting pseudo-obstruction. Clinical response with conservative care failed to improve the patient. 2.0 mg of neostigmine which was recently reported to be an effective way to decompress the colon in patients with acute colonic pseudo-obstruction, was administered. Immediate clinical response was achieved without complication.

A Case of Henoch-Sch nlein Purpura with Gastrointestinal Hemorrhage Diagnosed by Renal Biopsy / 대한소화기내시경학회지

Henoch-Sch nlein purpura is a systemic leukoclastic vasculitis with palpable purpura, gastrointestinal manifestations such as abdominal pain and gastrointestinal bleeding and renal problems. It is common in childhood, but can occur during adulthood. Adult have severer symptoms and worse prognosis than children. The pathogenesis of Henoch-Sch nlein purpura is autoimmune vasculitis mediated by immune complex such as IgA1. It is very helpful to find vasculitis and precipitation of immune complex (IgA1, C3) in the skin, gastrointestinal mucosal or renal biopsy for diagnosis. We report a case of Henoch-Sch nlein purpura with hematuria and proteinuria which could be diagnosed by renal needle biopsy due to absence of vasculitis findings in the skin and gastrointestinal mucosal biopsies. In summary, the pattern of evolution of this patient's dermatologic findings, gastrointestinal symptoms, bleeding, hematuria and proteinuria are typical of Henoch-Sch nlein purpura, but the definite diagnosis was very difficult due to absence of much related illness and no vasculitis in the skin and gastrointestinal mucosa. The meaning of renal biopsy in detection and management of Henoch-Sch nlein purpura with he maturia and proteinura was emphasized when vasculitis in the skin and gastrointestinal mucosa was not seen.

A Case of Pneumatosis Cystoides Intestinalis in a Patient with Systemic Sclerosis / 대한류마티스학회지

No abstract available.

Obstetric Outcomes in Patients with Systemic Lupus Erythematosus / 대한류마티스학회지

OBJECTIVE: To analyze the effect of clinical and serological variables of SLE on pregnancy outcome and to analyze the effects of pregnancy on the disease course of SLE. METHODS: We studied retrospectively about 91 pregnancies in 41 female patients with SLE, who had visted to Kangnam St Mary Hospital from January,1990 to May,1996. We divided the patients into two groups, who had been pregnant before SLE was established versus who were pregnant after SLE had been established. We considered the former as control group. We compared the fetal or maternal outcomes after divided the latter into subgroups according to our purposes such as cases with lupus flare versus without lupus flare, autoantibody (+) cases versus (-) cases, cases with renal disease versus without renal disease. RESULTS: The rate of fetal loss, prematurity was 19. 7%, 46. 9% respectively in 63 cases of 32 patients who were pregnant after SLE had been estabished. The number of pregnancy loss and premature delivery was higher in pregnancy after SLE was established than before SLE was established. Lupus flare was associated with the positivity of antibody to ds DNA and negativity of antibody to Ro. The frequency of fetal loss was higher in pregnancies of antiphospholipid (+) women than those of antiphospholipid (-) women. Pregnancy with renal involvement was associated with short duration of gestation and small body weight of neonate. CONCLUSION: Lupus pregnancy remains highly risky from a maternal standpoint in terms of increased lupus activity and from fetal outcome standpoint in terms of fetal loss and preterm birth, especially in the antiphosphospholid positive mother.