Estimating Nationwide Prevalence of Live Births with Down Syndrome and Their Medical Expenditures in Korea

BACKGROUND: This study aimed to estimate the nationwide prevalence of live births with Down syndrome (DS) and its trends and compare the observed and model-based predicted prevalence rates. Further, we compared the direct medical expenditures among DS and non-DS patients. METHODS: Using the health administrative data of Health Insurance Review and Assessment in Korea, we selected 2,301 children with DS who were born between 2007 and 2016 to estimate the prevalence of live births with DS, and 12,265 non-DS children who were born between 2010 and 2014 to compare the direct medical expenditures among patients. RESULTS: The prevalence of live births with DS was 5.03 per 10,000 births in 9 years, and 13% of children with DS were medical aid recipients during the study period. The medical expenditure of children with DS was about 10-fold higher than that of non-DS children and their out-of-pocket expenditure was about twice as high. CONCLUSION: The prevalence of live birth with DS is high in the low socioeconomic group and the healthcare costs for the children with DS are significantly higher than those for non-DS children. Therefore, health authorities should help mothers at lower socioeconomic levels to receive adequate antenatal care and consider the cost of medical care for children with DS.

Sudden Deafness in a Patient with Chronic Hepatitis C Treated with Peginterferon and Ribavirin Combination Therapy / 대한내과학회지

Combined peginterferon and ribavirin therapy for chronic hepatitis C is associated with several adverse side effects, but sudden deafness is uncommon. Here we report the case of a 62-year-old female with chronic hepatitis C (genotype 1b) who developed sudden deafness after completing 12 months of treatment with peginterferon alpha2a (180 microg/week) and ribavirin (1,000 mg/day). Pure-tone audiometry revealed a right-sided sensorineural hearing loss, which did not respond to 2 weeks of systemic corticosteroid therapy. Six months after the end of treatment for chronic hepatitis C, her qualitatively determined hepatitis C virus RNA level was 121,000 IU/mL. Following therapeutic failure, the patient was observed without retreatment for chronic hepatitis C or her hearing loss for a period of 12 months, during which time her hearing recovered almost completely.

A case of acute renal failure and IgA nephropathy associated with acute hepatitis A / 대한내과학회지

Hepatitis A is usually a mild, non-fulminant, self-limiting disease of the liver. Acute renal failure, in associated with non-fulminant hepatitis A, is extremely rare and is rarely documented by kidney biopsy. Here we report the case of a 28-year old male with acute non-fulminant hepatitis A who developed acute renal failure early in the course of the disease and recovered without dialysis. In this report, renal biopsy was done. The renal biopsy showed acute tubular necrosis and IgA nephropathy. We discuss the mechanism responsible for renal failure in acute hepatitis A virus infection on the basis of presumed pathogenesis and renal biopsy.