One Case of Acute Renal Failure with Toxic Hepatitis Caused by Bile Juice of Cyprinus Carpionudus / 영남의대학술지

The toxic effect of carp bile is well documented since earlier times but its exact mechanism of toxicity is unclear till now. Recently we have experienced a case of acute renal failure with toxic hepatitis in a 32-year-old man who ingested raw carp bile. He suffered from abdominal pain, nausea, vomiting and diarrhea, which occurred 3 hours after the ingestion of raw carp bile juice. Hematuria, proteinuria, oliguria and jaundice developed subsequently. 9 times of hemodialyses was performed and hepatitis was treated by conservative measure. The patient was discharged after 17 days of hospitalization. About 1 month after carp bile ingestion, no sequelae was detected. The authors report a case of acute renal failure due to carp bile juice ingestion with review of literature. Further study in needed as to the toxic substances of carp bile and pathogenesis.

A Case of Tsutsugamushi Disease / 영남의대학술지

Tsutsugamushi disease is an acute, febrile, typhus-like disease of rural Asia transmitted by the bite of larval trombiculid mites. The disease is caused by infection with Rickettsia tsutsugamushi. Recently the authors experienced a case of tsutsugamushi disease which was serologically confirmed. Here we report a case of tsutsugamushi disease which successfully managed with doxycycline and reviewed literatures on it briefly.

1 Case of Primary Aldosteronism Caused by Adrenal Hyperplasia / 영남의대학술지

Primary aldosteronism is a disease that the stimulus for the excessive aldosterone production residues within the adrenal gland. It was first described by conn in 1955. And many cases were reported by physicians at present in the world. But it is relatively rare in Korea, probably due to lack of attention and medical facilities. Only about 13 cases have been reported at present. The clinical, biochemical feature in l case of primary aldosteronism caused by adrenal hyperplasia that was diagnosed at Yeungnam University Hospital was observed and the following result were obtained. 1. Clinical feature: The present case was 27-year-old woman who was admitted due to general weakness and easy fatigability. The above mentioned chief complaints occurred 8 months prior to admission when she delivered of second baby by cesarean section. Symptoms such as above chief complaints, intermittent muscle paralysis and cramping were noticed. Trousseau's sign was also present. The average blood pressure ranged from 170/90 to 200/120 2. Biochemical abnormalities: Severe hypokalemia lower than 2.5 mEq/L was presented and 24 hours urine potassium showed markedly increased urinary loss (228 mEq/day). Plasma rennin activity was decreased under normal range with furosemide administration. (Basal renin; 0.01 ng/ml/hr, stimulated rennin 0.12 ng/ml/hr). Saline suppression test revealed markedly elevated levels of aldosterone higher than normal range (Basal aldosterone; 320.68 pg/ml stimulated aldosterone; 451.86 pg/ml). And posture test showed decreased plasma rennin activity and increased plasma aldosterone level. 3. Adrenal CT scan revealed no abnormal findings. 4. Treatment and course: Spironolactione was given at OPD with regular follow-up. Her blood pressure ranged from 150/90 to 160/100 and symptoms were improved. The effect of treatment was satisfactory and further follow up would be performed.