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1.
Korean Journal of Medicine ; : 785-790, 2014.
Artigo em Coreano | WPRIM | ID: wpr-85482

RESUMO

A 46-year-old man was admitted to our hospital because of a fever of unknown origin. The patient had a skin rash, arthralgia, and hepatosplenomegaly. Laboratory tests showed leukemoid leukocytosis, a high serum ferritin level (31,200 ng/mL), and abnormal liver function tests. He was initially diagnosed with adult-onset Still's disease (AOSD). However, imaging studies incidentally detected a cold abscess involving the 11th thoracic vertebra. A biopsy of the abscess revealed histologically granulomatous caseous necrosis, positive for M. tuberculosis by polymerase chain reaction. We present a patient with musculoskeletal tuberculosis (TB) that clinically mimicked AOSD. In TB-endemic countries, extrapulmonary TB should be included in the differential diagnosis of AOSD.


Assuntos
Humanos , Pessoa de Meia-Idade , Abscesso , Artralgia , Biópsia , Diagnóstico Diferencial , Exantema , Ferritinas , Febre de Causa Desconhecida , Leucocitose , Testes de Função Hepática , Mycobacterium tuberculosis , Necrose , Reação em Cadeia da Polimerase , Coluna Vertebral , Doença de Still de Início Tardio , Tuberculose
2.
Journal of Korean Medical Science ; : 190-197, 2014.
Artigo em Inglês | WPRIM | ID: wpr-35691

RESUMO

The objectives of this study were to estimate the cost-of-illness (COI) and health-related quality of life (HRQOL) in patients with ankylosing spondylitis (AS) in Korea and to evaluate the effects of socio-demographic and clinical factors on the COI and the HRQOL. Face-to-face interview surveys were taken from patients with AS at the Rheumatology Clinic of Seoul National University Hospital. Direct medical and non-medical costs, indirect costs (productivity loss due to job loss and sick leave), and deterioration of HRQOL in patients with AS were measured. Factors associated with COI and HRQOL were analyzed with multiple regression and multivariate logistic regression. A total of 191 patients with AS was enrolled in the study. The COI in patients with AS amounted to 11,646,180 Korean Won (KRW) per patient, and their HRQOL was 0.62. As functional severity worsened, the total costs increased (class I, KRW 7.7 million; class II, KRW 12.9 million; classes III & IV, KRW 25.2 million) and the HRQOL scores decreased (class I, 0.72; class II, 0.61; classes III & IV, 0.24). Functional severity is the major determinant of the COI and HRQOL in patients with AS.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anticorpos Monoclonais/uso terapêutico , Efeitos Psicossociais da Doença , Custos e Análise de Custo , Demografia , Entrevistas como Assunto , Modelos Logísticos , Qualidade de Vida , República da Coreia , Índice de Gravidade de Doença , Espondilite Anquilosante/tratamento farmacológico , Centros de Atenção Terciária
3.
Journal of Korean Medical Science ; : 1134-1138, 2013.
Artigo em Inglês | WPRIM | ID: wpr-135450

RESUMO

Tofacitinib, a novel Janus kinase inhibitor, may prevent structural damage in rheumatoid arthritis (RA). In this cohort study, we compared radiographic progression of hand joints between 21 RA patients who took tofacitinb for 18 months in a phase IIb and its extension study and 42 patients who took conventional disease modifying antirheumatic drugs (DMARDs), using simple erosion narrowing score. For tofacitinib group, changes before and after the treatment were also compared. The changes of erosion and sum scores were significantly less in tofacitinib than DMARDs group (for erosion, -0.60 +/- 1.83 vs 0.51 +/- 1.77, P = 0.038; for sum, -0.50 +/- 1.72 vs 1.57 +/- 4.13, P = 0.012). Joint space narrowing score (JSN) was also less in tofacitinib group (0.095 +/- 0.58 vs 1.06 +/- 2.60, P = 0.055). In tofacitinib group, yearly rates of both erosion and JSN were significantly decreased after administration of tofacitinib (For erosion, 0.62 +/- 0.93 to -0.14 +/- 0.48, P = 0.009; for JSN, 0.47 +/- 0.64 to 0.03 +/- 0.40, P = 0.032), as was change of sum score (1.09 +/- 1.27 to -0.10 +/- 0.63, P < 0.001). In conclusion, tofacitinib may prevent structural damage caused by RA.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Estudos de Coortes , Progressão da Doença , Piperidinas/uso terapêutico , Inibidores de Proteínas Quinases/uso terapêutico , Pirimidinas/uso terapêutico , Pirróis/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento
4.
Journal of Korean Medical Science ; : 1134-1138, 2013.
Artigo em Inglês | WPRIM | ID: wpr-135448

RESUMO

Tofacitinib, a novel Janus kinase inhibitor, may prevent structural damage in rheumatoid arthritis (RA). In this cohort study, we compared radiographic progression of hand joints between 21 RA patients who took tofacitinb for 18 months in a phase IIb and its extension study and 42 patients who took conventional disease modifying antirheumatic drugs (DMARDs), using simple erosion narrowing score. For tofacitinib group, changes before and after the treatment were also compared. The changes of erosion and sum scores were significantly less in tofacitinib than DMARDs group (for erosion, -0.60 +/- 1.83 vs 0.51 +/- 1.77, P = 0.038; for sum, -0.50 +/- 1.72 vs 1.57 +/- 4.13, P = 0.012). Joint space narrowing score (JSN) was also less in tofacitinib group (0.095 +/- 0.58 vs 1.06 +/- 2.60, P = 0.055). In tofacitinib group, yearly rates of both erosion and JSN were significantly decreased after administration of tofacitinib (For erosion, 0.62 +/- 0.93 to -0.14 +/- 0.48, P = 0.009; for JSN, 0.47 +/- 0.64 to 0.03 +/- 0.40, P = 0.032), as was change of sum score (1.09 +/- 1.27 to -0.10 +/- 0.63, P < 0.001). In conclusion, tofacitinib may prevent structural damage caused by RA.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Estudos de Coortes , Progressão da Doença , Piperidinas/uso terapêutico , Inibidores de Proteínas Quinases/uso terapêutico , Pirimidinas/uso terapêutico , Pirróis/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento
5.
Korean Journal of Medicine ; : 486-489, 2011.
Artigo em Coreano | WPRIM | ID: wpr-152852

RESUMO

The salient features of Sweet syndrome, also known as acute febrile neutrophilic dermatosis, are pyrexia, elevated neutrophil count, painful red papules, nodules, plaques, and an infiltrate that consists mainly of mature neutrophils diffusely distributed in the upper dermis. In addition to idiopathic forms of the syndrome, malignancies, inflammatory bowel disease, infections, pregnancy, and drugs have been associated with Sweet syndrome. Disseminated gonococcal infection (DGI) results from bacteremic dissemination of Neisseria gonorrhoeae. The most common presentation of DGI is arthritis-dermatitis syndrome. About 75% of DGI patients display a characteristic dermatitis consisting of discrete papules and pustules, often with a hemorrhagic component. We report a case of DGI presenting as Sweet syndrome.


Assuntos
Humanos , Gravidez , Dermatite , Derme , Febre , Doenças Inflamatórias Intestinais , Neisseria gonorrhoeae , Neutrófilos , Síndrome de Sweet
6.
Korean Journal of Gastrointestinal Endoscopy ; : 36-40, 2001.
Artigo em Coreano | WPRIM | ID: wpr-153638

RESUMO

The prevalence of intestinal tuberculosis has been markedly decreased with the development of antituberculous chemotherapy, improved economic conditions, preventive medicine and early detection and treatment of pulmonary tuberculosis. An even more impressive resurgence of pulmonary and extrapulmonary tuberculosis has been seen in recent years among persons infected with the human immunodeficiency virus. The most common site of intestinal tuberculosis is the ileocecal region, and duodenum is a rare site. Symptoms and signs of duodenal tuberculosis are nonspecific. The gross pathologic appearance of the duodenal tuberculous lesions has to its traditional categorization into three forms: 1) ulcerative, 2) hypertrophic, and 3) ulcerohypertrophic (mixed). Hypertrophic lesions of the duodenal tuberculosis should be differentiated from duodenal adenocarcinoma and lymphoma. We herein report a case of duodenal tuberculosis presenting as intraluminal protruding mass in gastroduodenoscopy and multiple intraabdominal lymphadenopathy on abdominal CT. We have confirmed the duodenal tuberculosis by endoscopic biopsy, and review the current literatures.


Assuntos
Humanos , Adenocarcinoma , Biópsia , Tratamento Farmacológico , Neoplasias Duodenais , Duodeno , HIV , Doenças Linfáticas , Linfoma , Prevalência , Medicina Preventiva , Tomografia Computadorizada por Raios X , Tuberculose , Tuberculose Pulmonar , Úlcera
7.
Korean Journal of Gastrointestinal Endoscopy ; : 49-52, 2001.
Artigo em Coreano | WPRIM | ID: wpr-153635

RESUMO

Impaction of an ingested foreign body in the colon is uncommon but surgical or endoscopic intervention is occasionally needed when serious complications such as perforation, obstruction or hemorrhage occur. Several factors may predispose a patient to ingestion and subsequent impaction of lower intestinal foreign body. It is more common in the elderly who wear dentures, in the mentally infirm, in chronic alcoholics or rapid eating. The majority of impaction occurs at narrowing and angulation such as ileocecal valve or rectosigmoid junction. The diagnosis of lower intestinal foreign body should be considered, among more common conditions, in the differential diagnosis of elderly patients who present with altered bowel habits. We report the case with a literature review that successfully endoscopically removed the fish bones impacted in the rectosigmoid colon complicated by rectal bleeding.


Assuntos
Idoso , Humanos , Alcoólicos , Colo , Dentaduras , Diagnóstico , Diagnóstico Diferencial , Ingestão de Alimentos , Corpos Estranhos , Hemorragia , Valva Ileocecal
8.
Korean Journal of Nephrology ; : 532-536, 2000.
Artigo em Coreano | WPRIM | ID: wpr-52607

RESUMO

Amphetamine toxicity is well known in western countries since several decades ago. Taken in excessive amount, amphetamine causes systemic symptoms such as hyperpyrexia, tachycardia, hyperkinesia, delirium, seizure and circulatory collapse. Acute renal failure following amphetamine ingestion is caused by the direct toxicity of the drug, circulatory collapse, coagulopathy, retroperitoneal hematoma or tubular obstruction by rhabdomyolysis. This is a case of a amphetamine intoxicated 41-year male patient presenting with features of acute renal failure, which is not accompanied by circulatory collapse, nor by coagulopathy. Muscle enzymes and bone scan findings were compatible with nontraumatic muscle injuries, and the renal pathology was tubular necrosis with specific myoglobin casts. Therefore a drug induced rhabdomyolysis causing myoglobinuric tubular injury is highly suspected. The fact that the outcome of the renal disease itself was good despite fatal dosage of this drug is also compatible with myoglobinuric renal failures reported by foreign authors. This is probably the first reported case of acute renal failure caused by amphetamine associated rhabdomyolysis in Korea.


Assuntos
Humanos , Masculino , Injúria Renal Aguda , Anfetamina , Delírio , Ingestão de Alimentos , Hematoma , Hipercinese , Coreia (Geográfico) , Mioglobina , Necrose , Patologia , Insuficiência Renal , Rabdomiólise , Convulsões , Choque , Taquicardia
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