1.A case of diffuse alveolar hemorrhage associatedwith Henoch-Schoenlein purpura.
Won Kyoung CHO ; Chae Man LIM ; Sang Do LEE ; Youn Suck KOH ; Woo Sung KIM ; Eun Sil YOO ; Dong Soon KIM ; Won Dong KIM
Tuberculosis and Respiratory Diseases 1996;43(3):461-466
Diffuse alveolar hemorrhage is a very rare manifestation in Henoch-Schoenlein purpura. Recently we experience a case of diffuse alveolar hemorrhage associated with Henoch-Schoenlein purpura which was diagnosed by typical clinical manifestation and renal biopsy. A 25 year old male was admitted due to hemoptysis and dyspnea. Chest X-ray, HRCT and BAL revealed diffuse alveolar hemorrhage. He also had a history of skin rash, polyarthralgia, and hematochezia with abdominal pain. Renal biopsy which was taken for the evaluation of microscopic hematuria showed IgA nephropathy. Under the diagnosis of Henoch-Schoenlein purpura, we treated him with solumedrol pulse therapy, plasma-pheresis and prednisolone with cytoxan. After then he showed marked improvement in clinical manifestation and was discharged with prednisolone and cytoxan.
Abdominal Pain
;
Arthralgia
;
Biopsy
;
Cyclophosphamide
;
Diagnosis
;
Dyspnea
;
Exanthema
;
Gastrointestinal Hemorrhage
;
Glomerulonephritis, IGA
;
Hematuria
;
Hemoptysis
;
Hemorrhage*
;
Humans
;
Male
;
Methylprednisolone Hemisuccinate
;
Prednisolone
;
Purpura, Schoenlein-Henoch*
;
Thorax
2.Methylprednisolone Pulse Therapy in Adult-Onset Minimal Change Nephrotic Syndrome.
Sook Eui OH ; Young Ki LEE ; Jin Kyung KIM ; Sung Tae CHO ; Rho Won CHUN ; Jong Woo YOON ; Ja Ryong KOO ; Hyung Jik KIM ; Jung Woo NOH ; Eun Suk NAM
Korean Journal of Nephrology 2007;26(6):677-683
PURPOSE: The incidence of complete remission is lower and the relapse is more frequent in adult-onset minimal change nephrotic syndrome (MCNS) are observed especially when compared with those in children. This study was designed to examine the effect of methylprednisolone pulse therapy in adultonset MCNS comparing to oral steroid as an initial therapeutic modality. METHODS: We have retrospectively reviewed the clinical data of 25 adult-onset MCNS patients. Twelve patients were treated with three intravenous pulses of methylprednisolone (1 g daily) followed by oral prednisolone 1 mg/kg daily for 4-8 weeks and also by low doses of oral prednisolone for 4-6 months (MP group) Thirteen patients were initially treated with oral prednisolone 1 mg/kg daily for 4-8 weeks and then with low doses of oral prednisolone (PD group). RESULTS: The response to therapy was similar between MP and PD group, with a complete remission obtained in 83.3% and 84.6%, respectively. No statistically significant difference between the two groups was observed in the rate of response at 8 weeks (58.3% versus 69.2%). The mean time to response was not different between MP group (37.9+/-28.0 days) and PD group (45.5+/-40.2 days). No difference was recognized between the two groups with respect to relapse rate. CONCLUSION: These data suggest that a short course of methylprednisolone pulse therapy followed by oral prednisolone is not superior to oral prednisolone therapy as an initial therapeutic modality in adult-onset MCNS.
Child
;
Humans
;
Incidence
;
Methylprednisolone*
;
Nephrosis, Lipoid*
;
Prednisolone
;
Recurrence
;
Retrospective Studies
3.A case of acute disseminated encephalomyelitis(ADEM) following rubella infection.
Sung Man JUN ; Dae Hyun KIM ; Jae Kwan CHA ; Sang Ho KIM ; Jae Woo KIM ; Won Tae CHUNG
Journal of the Korean Neurological Association 1997;15(5):1184-1188
Acute disseminated encepahalomyelitis(ADEM) is acute monophasic infammatory demyelinating disease of the central nervous systems occurring several days to two weeks after viral illness or vaccination. ADEM following rubella infection is very rare. We experienced a case of 24-years old man who developed confusion, nysmgmus, paraparesis, and voiding difficulty three days after the recovery form rubellar infection expressing skin rash and fever. CSF study showed pleocytosis(119cells/mm3), increased titer of [gM and IgG for rubella,, and myelin basic protein, whereas the level of the glucose and protein is normal. MRI of brain, cervical and thoracic spinal cord showed multiple high signa] intensities in the deep white matter of brain, entire cervical and upper thoracic spinal cord. He had been treated with high dose solumedrol intravenously for six days, and then oral prednisolone for ninteen days. Follow-up CSF study after seven days showed normal profiles and MRI after three weeks demonstrated remarkably decreased size of the previous lesions. He showed much improvement of neurologic symptoms except mild voiding difficulty. We report a case diagnosed as ADEM with good prognosis following rubella infection.
Brain
;
Central Nervous System
;
Demyelinating Diseases
;
Exanthema
;
Fever
;
Follow-Up Studies
;
Glucose
;
Humans
;
Immunoglobulin G
;
Magnetic Resonance Imaging
;
Methylprednisolone Hemisuccinate
;
Myelin Basic Protein
;
Neurologic Manifestations
;
Paraparesis
;
Prednisolone
;
Prognosis
;
Rubella*
;
Spinal Cord
;
Vaccination
;
Young Adult
4.Clinical Consideration of Prednisolone Induced Cataract.
Journal of the Korean Ophthalmological Society 2004;45(5):732-735
PURPOSE: The purpose of this paper was to examine the correlation between the development of posterior subcapsular cataract and the dosage and duration of systemic steroid therapy. METHODS: Twenty-two eyes which underwent cataract surgery at our ophthalmologic department were enrolled, along with 20 randomly selected eyes, which received prednisolone therapy at least for 1 year. We examined prednisolone dosage, duration and systemic disorders. We compare daily prednisolone dosage, and duration between the subcapsular opacity group and the non-subcapsular opacity group. SPSS, with 2 way- ANOVA system, was used for statistical analysis. RESULTS: The development of posterior subcapsular cataract was correlated with the daily prednisolone dosage, but not with the duration of prednisolone therapy (p<0.05). CONCLUSIONS: Careful attention to the daily steroid dosage is required to prevent posterior subcapsular cataract formation.
Cataract*
;
Prednisolone*
5.A Case of Systemic Lupus Erythematosus with Myelofibrosis.
Ju Sang PARK ; Seong Ho KIM ; Chan KIM ; You Sook CHO ; Bin YOO ; Hyun Sook CHI ; Hee Bom MOON
The Journal of the Korean Rheumatism Association 1998;5(1):108-115
A 42-year-old man presented with severe pancytopenia and uncontrolled epistaxis. The diagnosis of SLE was made and the pancytopenia was found to be due to myelofibrosis. The pulse therapy with methylprednisolone and maintenance therapy with prednisolone reversed both pancytopenia and myelofibrosis. Although myelofibrosis has been described in SLE, this coexistence must be very rare since there has been only 19 cases showing this combination. We report a case of SLE with myelofibrosis which was reversed by the treatment with glucocorticoid.
Adult
;
Diagnosis
;
Epistaxis
;
Humans
;
Lupus Erythematosus, Systemic*
;
Methylprednisolone
;
Pancytopenia
;
Prednisolone
;
Primary Myelofibrosis*
6.The Effects of Intravenous Methylprednisolone Pulse Therapy by Mendoza Protocol in Primary and Secondary Nephrotic Syndrome.
Kyoung Jae LEE ; Jae Hyuk HAN ; Young Mock LEE ; Ji Hong KIM ; Pyung Kil KIM
Journal of the Korean Society of Pediatric Nephrology 2001;5(2):117-124
PURPOSE: Since Mendoza(1990)'s report that long term methylprednisolone pulse therapy by Mendoza protocol (MP therapy) is a good treatment option in focal segmental glomerulo -sclerosis(FSGS), there have been reports of the effects of this therapy in steroid-resistant nephrotic syndrome. However, no studies have been performed on the effects of MP therapy in steroid-dependent nephrotic syndrome and secondary nephrotic syndrome. In this study, we investigated the effects of long term MP therapy in primary and secondary nephrotic syndrome in which previous treatment options were not effective. METHODS: We chose 10 children who were diagnosed with steroid-dependent minimal change nephrotic syndrome(SD-MCNS), who had shown frequent relapse during the immunocompromised or cytotoxic therapy period, and 6 children with FSGS and 5 children with secondary nephrotic syndrome children, who had shown no response during the previous therapy period. We treated these patients according to Mendoza protocol involving infusions of high doses of methyl- prednisolone, often in combination with oral cyclophosphamide for 82 weeks. RESULTS: In all the 10 children with SD-MCNS, complete remission was visible on average of 18+/- days after MP therapy was started. However, all these children relapsed during or after MP therapy. In these children, the mean relapse rate prior to MP therapy was 2.1+/-.0 relpases/year, which was reduced to 1.4+/-.9 relapses/year during MP therapy(P>0.05) and rose to 2.7+/-.0 relapse/year after MP therapy. Of the 6 children with FSGS, 4 children(67%) showed complete remission, of whom 3 children(50%) remained in the remission status during the follow up period, 1.2+/-.7 years, after the end of MP therapy. 2 children(33%) showed no response. All of the 5 children with secondary nephrotic syndrome showed remission and remained in the remissiom status during the follow up period, 1.7+/-.6 years. The only side effect of MP therapy was transient hypertension in 10 children of all subjects during the intravenous infusion of methylprednisolone. CONCLUSION: We conclude that although long term MP therapy is not effective in the treatment of SD-MCNS, it is an effective therapy against intractable FSGS and secondary nephrotic syndrome.
Child
;
Cyclophosphamide
;
Follow-Up Studies
;
Humans
;
Hypertension
;
Infusions, Intravenous
;
Methylprednisolone*
;
Nephrotic Syndrome*
;
Prednisolone
;
Recurrence
7.Thyrotoxic Periodic Paralysis Induced by Dexamethasone.
Eun Ju LEE ; Tae Kyoon KIM ; Min Jeong KWON ; Soon Hee LEE ; Jeong Hyun PARK
Endocrinology and Metabolism 2012;27(4):299-302
Thyrotoxic periodic paralysis (TPP) is a disease characterized by sudden onset and muscle paralysis. It occurs in the setting of hypokalemia of thyrotoxicosis. Cases of TPP induced by a glucocorticoid such as prednisolone or methylprednisolone have been reported. We report on two patients, each of whom received a dexamethasone injection and subsequently developed TPP. Both patients experienced sudden, flaccid paralysis of both extremities after the injection but recovered completely after receiving a potassium replacement. Laboratory results revealed thyrotoxicosis. The patients were diagnosed with Graves' disease and discharged after receiving treatment with methimazole and propranolol. This report provides the clinical description of TPP induced by dexamethasone injection. These cases suggest that clinicians must consider the presence of hyperthyroid disease in patients who develop acute paralysis after treatment with a glucocorticoid, even in the absence thyrotoxic symptoms. Furthermore, physicians should be aware that TPP can occur even in response to dexamethasone used for treatment of thyrotoxic crisis or Graves' ophthalmopathy.
Dexamethasone
;
Extremities
;
Graves Disease
;
Humans
;
Hypokalemia
;
Methimazole
;
Methylprednisolone
;
Muscles
;
Paralysis
;
Potassium
;
Prednisolone
;
Propranolol
;
Thyroid Crisis
;
Thyrotoxicosis
8.A Case of Toxic Amblyopia Caused by Methanol Intoxication.
Jae Soon BANG ; Hong Seok YANG ; Seung Soo RHO ; Yoon Hee CHANG
Journal of the Korean Ophthalmological Society 2007;48(12):1731-1735
PURPOSE: To report a case of visual improvement in methanol poisoning treated with intravenous methylprednisolone. CASE SUMMARY: A 64-year-old man presented with decreasing vision in both eyes after ingesting a car window cleanser. His initial visual acuity was the ability to count fingers in the right eye and hand motion in the left eye. The patient received intravenous methylprednisolone (1.0 gram), slowly over 1 hour. The same dose of methyl prednisolone was repeated on the second and third day. Then, oral prednisolone was given and tapered over a period of 7 weeks. On the 5th day after treatment, there was an improvement in the visual acuity of the right eye to 0.4 but no improvement of vision was observed in the left eye. On 16th day after treatment, the visual acuity was 0.7 in the right eye and counting fingers in the left eye. At 2 months after ingestion, the visual acuity of the right eye returned to 1.0 with no improvement in the left eye. Optic disc pallor was suspected and P100 delay was observed in the left eye with VEP showing a favorable outcome in the right eye. CONCLUSIONS: A visual improvement of 1 eye was observed in methanol poisoning treated with intravenous methylprednisolone.
Amblyopia*
;
Eating
;
Fingers
;
Hand
;
Humans
;
Methanol*
;
Methylprednisolone
;
Middle Aged
;
Pallor
;
Poisoning
;
Prednisolone
;
Visual Acuity
9.Clinical Manifestations of Optic Neuritis.
Yong Jae LEE ; Bong Leen CHANG
Journal of the Korean Ophthalmological Society 1997;38(11):1969-1974
Optic neuritis is an acute inflammatory disease of the optic nerve. Visual loss in optic neuritis is typically sudden and accompanied visual field defects. We attempted to characterize the clinical manifestations of optic neuritis based on visual acuity and visual field changes. Eighteen patients were included in this study who completed at least 3 month follow-up. we observed these patients with no medication in ten, with oral prednisolone in seven and with intravenous methylprednisolone in one. Statistically significant visual recovery occurred at first and second month and twenty eyes of 27 eyes (74%) had improved o.5 or more. Most common type of visual field defect was central scotoma (74%) and 85% of eyes who showed abnormal visual fields at first visit recovered normal visual field during follow-up period.
Follow-Up Studies
;
Humans
;
Methylprednisolone
;
Optic Nerve
;
Optic Neuritis*
;
Prednisolone
;
Scotoma
;
Visual Acuity
;
Visual Fields
10.14 Cases with Acute Diffuse Alopecia Areata.
Seung Ju BACK ; Myung IM ; Chang Deok KIM ; Young Joon SEO ; Jeung Hoon LEE ; Jang Kyu PARK
Korean Journal of Dermatology 2007;45(9):884-889
BACKGROUND: Acute diffuse alopecia areata (AA) was described as a unique AA which mimics anagen effluvium, or in which the initial hair loss is diffuse and followed by total denudation of scalp within several weeks or months. In spite of its peculiar clinical feature, there was neither further characterization nor known effective treatment for this form of AA. OBJECTIVE: To evaluate the characteristic clinical findings of acute diffuse AA and confirm the effect of high dose methyl prednisolone therapy. METHODS: The medical records of 13 patients with acute diffuse AA between January 2002 and April 2006 at the Department of Dermatology, Chungnam National University Hospital were reviewed. All patients were treated with high dose methylprednisolone therapy. RESULTS: Of the 13 patients who completed the study, 8 patients (61.5%) were male and 5 patients (38.5%) were female. The mean age was 29.6 years old. The progress of hair loss stopped 2.4 weeks on average after initial treatment and newly emerging hairs were recognized 4.1 weeks on average after initial treatment. 84.6% (11/13) of patients showed terminal hair growth, and 46.2% (6/13) of patients completely responded to this therapy. CONCLUSION: Acute diffuse alopecia areata can occur in male as well as in female patients. High dose methylprednisolone therapy appears to be effective in patients with rapidly progressing acute diffuse alopecia areata to prevent the progression of the disease.
Alopecia Areata*
;
Alopecia*
;
Chungcheongnam-do
;
Dermatology
;
Female
;
Hair
;
Humans
;
Male
;
Medical Records
;
Methylprednisolone
;
Prednisolone
;
Scalp