A case of acute disseminated encephalomyelitis with liver abscess / 대한내과학회지

Acute disseminated encephalomyelitis (ADEM) is an acute inflammatory demyelinating disease of central nervous system, and is related to allergic or immune-mediated reaction to systemic viral infection or vaccination, which is usually self limited monophasic illness. As the clinical manifestations or laboratory findings is nonspecific, it is diagnosed by brain magnetic resonance imaging (MRI) showing multiple foci of increased T2 signal within white matter. We report the clinical and radiologic imaging findings in a 36-year-old man in whom acute disseminated encephalomyelitis developed after serologically proven herpes infection combined with liver abscess. His clinical course, despite without corticosteroid or plasmapheresis because of liver abscess, was shown spontaneous remission.

A case of colon carcinoma in crohn's disease / 대한내과학회지

Crohn's disease is one of the chronic inflammatory disorders of unknown cause involving the gastrointestinal tract. The inflammation may occur in the colon, either alone or with small intestine. Crohn's disease has been associated with increased risk for coloretal carcinoma in patients with long-standing colitis, strictures and fistulae. Recently, we experienced a case of Crohn's disease complicating carcinoma in a 85 year old male. Ten years ago, he compained severe abdominal pain and diarrhea. and was detected colon obstruction and enteric fistula. But, he spontaneously improved. Recently, the patient was admitted complaining abdominal pain. He complaind abdominal pain and indigestion chronically and aggravated recently. He was examined with colonofibroscopy, and computered tomography, and carcinoma was detected at the site of Crohn's disease.

A case of rotor syndrome / 대한내과학회지

Rotor syndrome is a rare benign familial disorder characterized by chronic, fluctuating, nonhemolytic and predominantly conjugated hyperbilirubinemia with normal liver tissue. In contrast to Dubin-Johnson syndrome, there is no liver hyperpigmentation in Rotor syndrome, and BSP clearance does not show a secondary retention peak. The serum bilirubin in patients with Gilbert's syndrome is almost all unconjugated in contrast to Rotor syndrome. A 29-year-old male was admitted due to persistent jaundice. Physical examination revealed icteric sclera without hepatosplenomegaly. Laboratory findings showed increased serum bilirubin with indirect bilirubin predominance. Urinary excretion of total coproporphyrin was markedly elevated, and coproporphyrin I was 66% of total urinary coproporphyrin. Oral cholecystography showed well visualized the gallbladder, but 99mTc-DISIDA scan showed markedly decreased hepatic uptake and poor visualization of the gallbladder and biliary tract. Histology of the liver showed no abnormal finding. We report the case with the review of literature.