No abstract available.
Humans ; Hypoalbuminemia* ; Scrub Typhus*

Systemic lupus erythematosus (SLE) is a multisystemic disease that can affect most organ system, although gastrointestinal (GI) manifestations are relatively uncommon. Protein losing enteropathy (PLE) is associated with several clinical disorders, but it is an unusual manifestation of SLE. Of over 20 reported cases of PLE associated with SLE, the pathogenesis of lupus associated PLE remains unclear. We describe a patient with edema, diarrhea, abdomianl pain, and hypoalbuminemia who had been diagnosed SLE. PLE was diagnosed by the method of alpha1-antitrypsin clearance in stool.
Diarrhea ; Edema ; Humans ; Hypoalbuminemia ; Lupus Erythematosus, Systemic* ; Protein-Losing Enteropathies*

Systemic capillary leak syndrome (SCLS), also called Clarkson's disease is rare and life-threatening disorder of unknown etiology, which is a characteristic triad of hypovolemic shock, hemoconcentration, and hypoalbuminemia. Unexplained capillary leakage from the intravascular to the interstitial space, which has been estimated up to 70% of the intravascular volume, is the proposed mechanism. Because the pathogenesis is unknown, it is diagnosed clinically after exclusion of other diseases that cause systemic capillary leak and no efficacious pharmacological treatment has been clearly established. The mortality rate ranges from 30% to 76%. In Korea, four cases of SCLS (5 cases in adult and 1 case in child) were reported by 2012. We describe a case of severe SCLS that suddenly occurred and rapidly progressed during pylorus preserving pancreaticoduodenectomy and review the literature.
Adult ; Capillaries ; Capillary Leak Syndrome* ; Humans ; Hypoalbuminemia ; Korea ; Mortality ; Pancreaticoduodenectomy* ; Pylorus ; Shock

Nephrotic syndrome is associated with a hypercoagulable state, which results in thromboembolism as one of its main complications. Various pathogenetic factors that cause the hypercoagulable state in nephrotic syndrome have been recognized. We report on a 19-year-old female with a minimal-change disease who developed pulmonary thromboembolism combined with intracardiac thrombus while on tapering steroid. Our patient showed hypoalbuminemia with an episode of shock, and was successfully treated with thrombolysis and anticoagulation therapy.
Female ; Humans ; Hypoalbuminemia ; Nephrotic Syndrome* ; Pulmonary Embolism* ; Shock ; Thromboembolism ; Thrombosis* ; Young Adult

Pseudomembranous colitis (PMC) is mostly related with the antibiotics and it presents with diarrhea, abdominal pain, fever, hypoalbuminemia and hypovolemia. In the clinical course of pseudomembranous colitis (PMC), ascites is a rare presentation, and high elevation of carcinoembryonic antigen (CEA) associated with PMC is also a very rare presentation. We experienced a case taken cephalosporin group antibiotics for six weeks and presented with fever, abdominal pain, severe diarrhea, and massive ascites. During evaluation, we found low serum-ascites albumin gradient and high level of CEA in both ascites and plasma. With the impression of hidden malignancy, the special studies were done, but PMC was only found without malignancy. After vancomycin therapy, all symptoms were relieved and CEA level declined.
Abdominal Pain ; Anti-Bacterial Agents ; Ascites* ; Carcinoembryonic Antigen ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Fever ; Hypoalbuminemia ; Hypovolemia ; Plasma ; Vancomycin

Pulmonary edema in surgical patients is known to be a complication resulting from various causative factors. We have analysed 10 cases observed in the Dong San Medical Center and 18 cases reported in the Journal of the Korean Society of Anesthesiologists in terms of sex, age, causing factor, onset, therapy etc. As a result of this study, the summary is as follows: 1) The most common causes of pulmonary edema in surgical patients were overloading, followed by heart failure, hypoalbuminemia, sepasis, severe trauma and unknown causes in that order. 2) Pulmonary edema can develop in any surgical patient without a direct realtionship to age, sex or type of peration. 3) The incidence tended to be higher in emergency patients than in elective patients because their general condition was worse and the surgical procedures were done in such haste. 4) The onset of pulmonary edema seems to occur commonly at the end of surgery, particularly when the patients were extubated and then followed by endotracheal suction because negative pressure is applled for suction as the positive pressure was removed for extubation. 5) Active therapy for pulmonary edema has been generally successful because of advanced respiratory care with various sophisticated respirators.
Emergencies ; Heart Failure ; Humans ; Hypoalbuminemia ; Incidence ; Pulmonary Edema* ; Suction ; Ventilators, Mechanical

Protein energy malnutrition occurs when inadequate protein and calories are ingested. PEM is not confined to children and is common in hospitalized patients. PEM is diagnosed by a weight loss and hypoalbuminemia. We report a case of PEM in a 27-year-old man after Whipple's operation. He had brittle hair, loss on the scalp and brownish colored papules with desquamation on extremities. Also he had erosion and fissuring on the perioral area and beef tongue. Treatment with zinc sulfate, albumin and vitamin resulted in a good response.
Adult ; Child ; Extremities ; Hair ; Humans ; Hypoalbuminemia ; Protein-Energy Malnutrition* ; Scalp ; Tongue ; Vitamins ; Weight Loss ; Zinc Sulfate

BACKGROUND: Hypoalbuminemia is the most important risk factor for death in dialysis patients. But, it is not well known the factors determining the changes of serum albumin with time. The present study attempts to address the changes of serum albumin with time and the factors determining the changes of serum albumin in stable patients on peritoneal dialysis. METHODS: Fifty-four peritoneal dialysis patients in stable condition were included. Serum albumin, peritoneal equilibration test, weekly urea clearance (Kt/V), weekly creatinine clearance(CCr) and normalized protein catabolic rate(nPCR) were determined two times(mean 5.8+/-2.3 months and 31.3+/-6.5 months after initiation of peritoneal dialysis). RESULTS: Initially lower serum albumin group patients(below 3.7 g/dL) showed significantly increased serum albumin level with time(3.2+/-0.43 g/dL vs 3.57+/-0.52 g/dL, p=0.006) and initially higher serum albumin group patients(above 3.7 g/dL) showed decreased serum albumin level with time(4.07+/-0.32 g/dL vs 3.97+/-0.3 g/dL, p=0.15). Serum albumin changes(delta) were significantly higher in initially lower serum albumin group than higher serum albumin group(0.37+/-0.6 g/dL vs -0.11+/-0.3 g/dL, p < 0.01). There were negative correlations between delta serum albumin and delta D/PCr with time in initially lower and initially higher serum albumin groups(0.37+/-0.56 g/dL vs -0.02+/-0.11, -0.11+/-0.33 g/dL vs 0.05+/-0.12, respectively, r=-0.308, p=0.008). The group which increased serum albumin level with time showed significantly lower initial serum albumin(3.32+/-0.51 g/dL vs 3.98+/-0.46 g/dL, p < 0.001) and significantly decreased D/P(Cr) changes(-0.03+/-0.09 vs 0.06+/-0.10, p= 0.02) than the group which decreased serum albumin level with time. With multiple regression analysis, initial serum albumin level and the change of D/P(Cr) were significant predictors of the change of serum albumin with time. CONCLUSION: Initial serum albumin and the change of D/PCr were identified as the predictors of the change of serum albumin in stable peritoneal dialysis patients.
Creatinine ; Dialysis ; Humans ; Hypoalbuminemia ; Peritoneal Dialysis* ; Risk Factors ; Serum Albumin* ; Urea

Subarachnoid hemorrhages (SAH) result in hemodynamic and metabolic abnormalities. The successful treatment of these abnormalities requires active treatment of neuroprotection. Recently, it has been known that albumin has important roles in neuroprotection as well as in hemodilution. We retrospectively studied 64 patients who were treated surgically for aneurysmal SAH to investigate the relationship between serum albumin levels, severity of disease and neurological outcomes. A high proportion of patients developed hypoalbuminemia after aneurysmal SAH. Patients with poor clinical presentation had significantly lower admission and postoperative albumin values than those with good clinical presentation. Comparison of patients with a favorable outcome and those with an unfavorable outcome revealed a significant difference in postoperative albumin values. In the patients with severe clinical presentation, postoperative albumin levels lower than 3.5 g/dL were associated with an unfavorable outcome. As a result of our analysis, albumin is an important prognostic factor in aneurysmal SAH. Therefore, active albumin replacement therapy might improve neurological outcomes as a neuroprotective agent. We therefore suggest that albumin offers great promise in the therapy of complications of SAH and we propose that it may now be appropriate to consider the initiation of early-phase clinical trials in patients with aneurymal SAH.
Aneurysm ; Hemodilution ; Hemodynamics ; Humans ; Hypoalbuminemia* ; Retrospective Studies ; Serum Albumin ; Subarachnoid Hemorrhage*

Subarachnoid hemorrhages (SAH) result in hemodynamic and metabolic abnormalities. The successful treatment of these abnormalities requires active treatment of neuroprotection. Recently, it has been known that albumin has important roles in neuroprotection as well as in hemodilution. We retrospectively studied 64 patients who were treated surgically for aneurysmal SAH to investigate the relationship between serum albumin levels, severity of disease and neurological outcomes. A high proportion of patients developed hypoalbuminemia after aneurysmal SAH. Patients with poor clinical presentation had significantly lower admission and postoperative albumin values than those with good clinical presentation. Comparison of patients with a favorable outcome and those with an unfavorable outcome revealed a significant difference in postoperative albumin values. In the patients with severe clinical presentation, postoperative albumin levels lower than 3.5 g/dL were associated with an unfavorable outcome. As a result of our analysis, albumin is an important prognostic factor in aneurysmal SAH. Therefore, active albumin replacement therapy might improve neurological outcomes as a neuroprotective agent. We therefore suggest that albumin offers great promise in the therapy of complications of SAH and we propose that it may now be appropriate to consider the initiation of early-phase clinical trials in patients with aneurymal SAH.
Aneurysm ; Hemodilution ; Hemodynamics ; Humans ; Hypoalbuminemia* ; Retrospective Studies ; Serum Albumin ; Subarachnoid Hemorrhage*