- An overlap syndrome of Churg-Strauss syndrome and rheumatoid arthritis.
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Seung Il Bae, Jong Geol Jang, Hun Tae Kim, Hee Yun Ahn, Min Jung Kim, Hyun Je Kim, Choong Ki Lee, Young Hoon Hong
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Yeungnam Univ J Med. 2015;32(2):127-131. Published online December 31, 2015
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DOI: https://doi.org/10.12701/yujm.2015.32.2.127
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- Churg-Strauss syndrome (CSS) is a necrotizing vasculitis with extra-, peri-vascular eosinophilic infiltration. Chronic symmetric polyarthritis with the presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody are the mainstay of rheumatoid arthritis (RA) diagnosis. Mononeuritis multiplex is a peripheral neuropathy involving more than 2 separate nerve areas. A 62-year-old male patient was referred for left foot drop and polyarthritis of both hands and feet for 4 months. During evaluation, mononeuritis multiplex was detected on nerve conduction study and electromyography tests: vasculitis with neutrophil, eosinophil, and lymphocyte infiltration on peroneal nerve biopsy. A positive response to methacholin and bronchodilator was observed on the pulmonary function test. Radiologic tests showed peri-articular soft tissue swelling and osteopenia on both hand and foot. Marked peripheral eosinophilia, high RF, and positive perinuclear anti-neutrophil cytoplasmic antibody were detected on blood tests. Here, we report on a patient with overlap syndrome of CSS and RA with review of the relevant literature, from which a few references to overlap syndrome of CSS and RA were available.
- Immune thrombocytopenia associated with sarcoidosis.
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Da Eun Jeong, Min Kyoung Kim, Sung Ae Koh, Kyoung Hee Lee, Joon Hyuk Choi, Young Hoon Hong, Jae Ho Cho, Eun Ju Goo, Myung Soo Hyun
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Yeungnam Univ J Med. 2015;32(1):26-30. Published online June 30, 2015
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DOI: https://doi.org/10.12701/yujm.2015.32.1.26
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- Sarcoidosis is a systemic disease of unknown cause involving multiple organs and is characterized by noncaseating granuloma. Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased peripheral platelet destruction due to the presence of an antibody to the platelet and abnormal platelet production. There is no known pathogenesis that occurs concurrently with ITP and sarcoidosis. However, considering together of 2 known pathogenesis, abnormal immune response triggers either ITP or sarcoidosis. The disease that develops first stimulates secondary disease. After development of secondary disease, they stimulate each other. A few cases of ITP associated with sarcoidosis are well documented in English; however, the disease has rarely been reported in Korea. Here, we report on a case of ITP with sarcoidosis in a 29-year-old man. He suffered from easy bruising. The chest X-ray and the contrast-enhanced computed tomography scan showed bihilar lymphadenopathy and reticulonodular infiltrates. Bone marrow study and fluoroscopy-guided percutaneous needle biopsy were performed and the patient was diagnosed with sarcoidosis and ITP. He was put on 400 mg/kg of intravenous immunoglobulin for 5 days and administered oral steroids and further follow-up will be carried out. He has shown a good response without significant bleeding event. However, administration of more oral steroid and additional follow-up is required than for single disease, whether sarcoidosis or ITP.
- A Case of Pseudolymphomatous IgG4-Related Disease Involving the Maxilla.
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Min Jung Kim, Seung Il Bae, Hoon Tae Kim, Young Hoon Hong, Hyun Je Kim, Choong Ki Lee, Mi Jin Gu
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Yeungnam Univ J Med. 2013;30(2):128-131. Published online December 31, 2013
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DOI: https://doi.org/10.12701/yujm.2013.30.2.128
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- Immunoglobulin G4 (IgG4)-related disease is an inflammatory condition characterized by IgG4 positive plasma cell infiltration. It can affect any organ in the body and mainly involves the pancreas, liver, biliary tracts, orbits, salivary glands and lymph nodes. It can manifest as an inflammatory pseudotumor. Pseudolymphoma as an inflammatory pseudotumor is a group of benign tumors that exhibit histological and clinical features suggestive of malignant lymphoma. Studies on IgG4-related disease are rarely reported, and no case of the disease that involved the maxillary bone and adjacent soft tissue, except for the skin, has been reported. Therefore, we report herein a case of pseudolymphomatous IgG4-related disease that involved the maxilla, with a literature review.
- A Case of Systemic Lupus Erythematosus Misdiagnosed as Adult-onset Still's Disease.
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Myung Jin Oh, Hyun Je Kim, Han Sol Lee, Ji An Hur, Young Hoon Hong, Choong Ki Lee
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Yeungnam Univ J Med. 2010;27(1):78-84. Published online June 30, 2010
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DOI: https://doi.org/10.12701/yujm.2010.27.1.78
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- Adult-onset Still's disease (AOSD) is an inflammatory disorder that's characterized by daily, spiking high fever, arthritis and an evanescent, salmon-pink rash. AOSD is diagnosed purely on the basis of the typical clinical features of the illness. The symptoms commonly include swelling of the lymph nodes, enlargement of the spleen and liver, and a sore throat. AOSD is difficult to differentiate from systemic lupus erythematosus (SLE) due to the similar clinical manifestations. We report here on a case of a 16-year-old female patient with autism and epilepsy and who complained of daily spiking fever for 20 days. The patient had maculopapular skin rashes on the face and whole body and lymphadenopathy. The liver function tests were elevated mildly. The initial rheumatoid factor (RF) and antinuclear antibody (ANA) tests were negative. We diagnosed her as having adult-onset Still's disease according to the criteria of Yamaguchi. We successfully treated her with oral prednisolone. But her antinuclear antibody test was changed to positive after discharge. So we finally diagnosed her as having SLE.
- Three Cases of Fever Unknown Origin with Lymphoproliferative Features and a Unique Pattern of 18-FDG Uptake on the Fusion PET/CT.
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Dae Young Yun, Young Hoon Hong, Yong Uk Jung, Myung Jin Oh, Choong Ki Lee
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Yeungnam Univ J Med. 2008;25(1):64-71. Published online June 30, 2008
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DOI: https://doi.org/10.12701/yujm.2008.25.1.64
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- Evaluation of a fever of unknown origin (FUO) is complex. Recently, PET scanning has been approved for screening in FUO evaluation. We treated three cases of FUO associated with increased FDG uptake in the bone marrow of the femur and tibia on the fusion PET/CT; all three had the same pattern of uptake. Bone marrow biopsies revealed mature lymphocyte and histiocyte infiltration and myxoid changes in one case, and cortical bone involvement in another case. The cases were all young females who had fever with neutropenia and relative lymphocytosis that lasted for several weeks and then remitted spontaneously. Even though the results of the studies were not diagnostic, the unique uptake pattern on PET/CT and the histology might be related to the cause of the illness and should be studied further to assess the association with classic FUO.
- Identification of Interleukin 1-Responsive Genes in Human Chondrosarcoma SW1354 cells by cDNA Microarray Technology.
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Jun Ha Jeon, Yong Wook Jung, Dae Young Yun, Hyun Do Kim, Chang Mo Kwon, Young Hoon Hong, Jae Ryong Kim, Choong Ki Lee
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Yeungnam Univ J Med. 2007;24(1):24-40. Published online June 30, 2007
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DOI: https://doi.org/10.12701/yujm.2007.24.1.24
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- BACKGROUND
Accumulating evidence shows that interleukin(IL)-1 plays a critical role in inflammation and connective tissue destruction observed in both osteoarthritis and rheumatoid arthritis. IL-1 induces gene expression related to cytokines, chemokines and matrix metalloproteinases by activation of many different transcription factors. MATERIALS AND METHODS: The chondrosarcoma cell line, SW1353, is known to be a valuable in vitro system for investigating catabolic gene regulation by IL-1beta in chondrocytic cells. To explore and analyze the changes in gene expression by IL-1 responsible for arthritis, SW1353 was treated with IL-1 for 1, 6 and 24 h and then total RNAs were purified for each time. The changes in gene expression were analyzed with 17k human cDNA microarrays and validated by semi-quantitative RT-PCR. RESULTS: Greater than a two-fold change was observed in 1,200 genes including metallothioneins, matrix metalloproteinases, extracellular matrix proteins, antioxidant proteins, cytoskeleton proteins, cell cycle regulatory proteins, proteins for cell growth and apoptosis, signaling proteins and transcription factors. These changes appeared to be correlate with the pathophysiological changes observed in early osteoarthritis. CONCLUSION: cDNA microarray analysis revealed a marked variability in gene expression, and provided insight into the overall molecular changes. The result of this study provide initial information for further studies to identify therapeutic targets in osteoarthritis pathogenesis.
- The Clinical Effects of Cefpirome for the Treatment of Acute Lower Respiratory Infection.
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Kyeong Cheol Shin, Young Hoon Hong, Eun Young Lee, Ki Do Park, Sung Dong Kim, Jin Hong Chung, Choong Ki Lee, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee
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Yeungnam Univ J Med. 1999;16(2):219-227. Published online December 31, 1999
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DOI: https://doi.org/10.12701/yujm.1999.16.2.219
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- BACKGROUND
In contrast to a healthy person, patients who have acute lower pespiratory tract infection with underlying pulmonary diseases have various pathogens, a rapidly progressie downhill course, and a poor response to prior antimicrobial therapy. Broad spectrum antivacterial therapy is needed for full evaluation. MATERIALS AND METHODS: To evaluate the efficacy and safety of cefpirome, we administered 1gm cefpirome, twice a day to 30 patients who had signs and symptoms of acute lower repiratory infection regardless of their underlying disease, except to those who had an allergic history to antibiotics or severe systemic diseases. RESULTS: The results were as follows : 1) Among 30 cases, 21 cases(70.0%) showed excellent improvement, and 7 cases(23.3%) showed good improvement in their symptoms and signs of acute lower respiratory infection. 2) In 14 cases with isolated pathogens, we observed bacteriologic eradication in 11 cases(78.6%). 3) Significant side effects were not found CONCLUSION: Above results suggest that cefpirome was effective as a monotherapy in patients with acute lower respriatory infection, especially on those with as underlying chronic obstructive pulmonary disease(COPD).
- Two Cases of Systemic Lupus Erythematosus with Cerebrovascular Involvement.
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Bong Jun Kim, Eun Young Lee, Young Hoon Hong, Ki Do Park, Young Doo Song, Choong Ki Lee, Young Ran Shim
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Yeungnam Univ J Med. 1998;15(2):371-380. Published online December 31, 1998
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DOI: https://doi.org/10.12701/yujm.1998.15.2.371
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- Systemic lupus erythematosus(SLE) is an autoimmune disease which may affect many different organs and disclose various clinical manifestations. Recently central nervous system(CNS) involvement has been recognized as an increasingly significant contributor to morbidity and mortality of SLE. The clinical manifestations of CNS-lupus are highly variable and range from mild cognitive dysfunction, movement disorder, headache, psychosis to life-threatening stroke and coma. Among the neuropsychiatric disorders encountered in patients with SLE, cerebrovascular disease has been a relatively rare complication. The diagnosis and management of CNS-lupus is difficult because of the lack of useful diagnostic methods. If, cerebrovascular involvement is suspected, then aggressive treatment such as high dose steroid, immunosuppressive therapy, plasma exchange, may be required to reduce high mortality rate. We experienced 2 cases cerebrovascular disease occurring in SLE patients which presented with various neuropsychiatric manifestations. They were diagnosed as CNS-lupus by neuropsychiatric symptoms, brain MRI, and EEG, and showed good response to high dose steroid pulse therapy.
- 8 cases of delayed onset P. vivax malaria.
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Young Do Song, Jae Chun Lee, Young Hoon Hong, Eun Young Lee, Bong Jun Kim, Choong Ki Lee, Jin Young Moon
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Yeungnam Univ J Med. 1997;14(2):467-473. Published online December 31, 1997
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DOI: https://doi.org/10.12701/yujm.1997.14.2.467
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- South Korea has been free from endemic malaria by P. vivax since the mid-1980s, but malaria infections, including military outbreak in 1995, have been increasing steadily in the soldiers serving near the western part of Demilitarized Zone(DMZ) since its first resurgence in 1993. We experinced 8 cases of delayed onset P. vivax malaria in young men who had never been abroad and had no history of blood transfusion or parenteral use of drug. All the patients had served near the western part of DMZ during their military life. They were admitted to Yeungnam University hospital due to cyclic fever with chills and the clinical symptoms were developed 2 months to 11months after discharge from military service. Peripheral blood smears showed typical ring forms and trophozoites of P. vivax in red blood cell. Patients were treated with hydroxychloroquine and primaquine showing rapid clinical and hematologic responses in all cases, but 2 cases were relapsed later. We presumed that theses cases were delayed onset of P. vivax infection resulted from the recent outbreak in the western part of DMZ, in 1995. Therefore, we reported theses cases to emphasize the need of active surveillance and prevention.
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