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*

Most patients with nephrotic syndrome visit the hospital because of edema due to hypoalbuminemia induced by severe proteinuria. However, rare cases have reported arterial thrombosis as the main problem complicating nephrotic syndrome. Arterial thrombosis combined with nephrotic syndrome is rarer than venous thrombosis, and it usually develops during treatment with steroids or diuretics. Arterial thrombosis is rarely diagnosed as the initial sign of nephrotic syndrome. We report the case of a 38-year-old-woman with membranous glomerulonephritis presenting with right common iliac artery thrombosis as the initial sign.
Diuretics ; Edema ; Glomerulonephritis, Membranous ; Humans ; Hypoalbuminemia ; Iliac Artery ; Nephrotic Syndrome ; Proteinuria ; Steroids ; Thrombosis ; Venous Thrombosis

BACKGROUND/AIMS: Some clinical and laboratory parameter are predictors to determine steroid treatment failure in patients acute severe ulcerative colitis. We aimed to validate previous models in the Korean patients. METHODS: This study was conducted retrospectively with 70 patients who were diagnosed with severe ulcerative colitis (UC) between January 2001 and June 2011. The rate of treatment failure was investigated using predictors or numerical scoring systems from prior studies. RESULTS: Twelve (17.2%) patients failed to respond to steroid therapy. The logistic regression analysis revealed that stool frequency on the fifth day and colonic dilatation were the only independent predictive factors related to treatment failure. Formulated numerical risk scores based on mean stool frequency, colonic dilatation, and hypoalbuminemia were significantly higher in the non-responding group than those in the responding group (P<0.001). Using another scoring system (stool frequency on the third day+1.4xC-reactive protein [CRP]), treatment failure rate was significantly higher in the group in which the score was >8 than in the group with a score <8 (30.8% vs. 8.6%, P=0.042). Lastly, treatment failure rate was higher in the group (stool frequency >8 plus CRP >4.5 mg/dL or bloody stool plus CRP >4.3 mg/dL) than those of the other group at the third day (40% vs. 7.3%, P=0.004; 33.3% vs. 5.2%, P=0.014, respectively). CONCLUSIONS: Stool frequency and CRP level were the meaningful parameters among the predictors for steroid treatment response. Furthermore, several predictive models for steroid treatment failure in western countries seem to be of value for use in the Korean population.
Adrenal Cortex Hormones ; Colitis, Ulcerative ; Colon ; Dilatation ; Humans ; Hypoalbuminemia ; Logistic Models ; Retrospective Studies ; Treatment Failure ; Ulcer

BACKGROUND/AIMS: Menetrier's disease is a poorly defined condition that is of unknown origin, characterized by giant folds in the stomach. The histologic features are foveolar hyperplasia and cystic dilatation of the gland. We presented the characteristic findings of Menetirer's disease in Korea with a review of literatures to understand the Menetirer's disease more precisely. METHODS: The sixteen cases of Menetrier's disease was reported in Korea. We analyzed their age, sex, symptoms, signs, laboratory findings and treatments, retrospectively. RESULTS: The average age was 46 years. There were 11 men and 4 women. The most common symptom was epigastric pain (94%). The most common sign were epigastric tenderness (69%) and pretibial pitting edema (63%). Patients were often associated with the hypoalbuminemia (73%). All patients showed hypertrophic folds on either gastrofiberscopy or upper gastrointestinal series. All patients showed foveolar hyperplasia histologically. Three patients were operated to control a massive upper gastrointesinal bleeding. Two patients were operated to control the intractable edema. Two patients were operated to exclude gastric malignancy. CONCLUSIONS: Menetrier's disease showed broad clinical features such as epigastric pain, hypoalbuminemia, massive hematemesis and mimicking gastric malignancy. The giant gastric folds and foveolar hyperplasia were the most commom and important findings in the Menetrier's disease.
Dilatation ; Edema ; Female ; Gastritis, Hypertrophic* ; Hematemesis ; Hemorrhage ; Humans ; Hyperplasia ; Hypoalbuminemia ; Korea* ; Male ; Retrospective Studies ; Stomach

BACKGROUND/AIMS: Ascites is a fairly common condition, but the clinical features of pseudomembranous colitis with ascites are not well-known. The aim of this study was to determine how the existence of ascites is related to the clinical factors. METHODS: Between March 2002 and June 2006, 67 pseudomembranous colits patients were diagnosed by performing lower endoscopy and biopsy. The patients' ascites was identified by abdominal plain radiography, ultrasonography or computerized tomography. The extension of colitis was evaluated by ultrasonography or computerized tomography. RESULTS: 16 patients (23.9%) had ascites. The serum WBC (p=0.01), hypoalbuminemia (p<0.01), CRP (p<0.01), recurrence (p<0.01), and extension of colitis (p<0.01) were associated with the existence of ascites. The four patients who had undergone paracentesis had a low SAAG level and PMN dominant ascites. CONCLUSIONS: There were correlations of ascities with leukocytosis, hypoalbuminemia, CRP, extension of colitis and recurrence of PMC.
Ascites* ; Biopsy ; Colitis ; Endoscopy ; Enterocolitis, Pseudomembranous* ; Humans ; Hypoalbuminemia ; Leukocytosis ; Paracentesis ; Radiography ; Recurrence ; Ultrasonography

BACKGROUND: Early detection and treatment of chronic kidney disease (CKD) are important for inhibition of kidney disease progression and prevention of cardiovascular complications. Treatment of Anemia that is frequently accompanied with CKD, are important for prevention of cardiovascular complications. The lastest K/DOQI-CKD guideline targets early detection and treatment of kidney disease, and the study for these are necessary in Korea. In Korea, until mowadays, the study for prevalence, severity of anemia and influencing factors on anemia in CKD , were rare. Thus in our center, we classified patient for severity of CKD as K/DOQI-CKD guideline and studied prevalence, severity of anemia and influencing factors on anemia. METHODS: According to K/DOQI-CKD guideline, patients were staged by GFR calculated by Adbbreviated MDRD Study Equation. Anemia was defined by Hb less than 10.0 g/dL below which hemodynamic change develops. We examined the frequency of anemia and independent factors that influences on anemia in study patients. RESULTS: Mean creatinine levels for stage 1 to 5 were 0.87 +/- 0.15 (0.7-1.1) mg/dL; 1.04 +/- 0.18 (0.8-1.4) mg/dL; 1.69 +/- 0.36 (1.1-2.7) mg/dL; 2.90 +/- 0.66 (1.9- 4.7) mg/dL; 5.01 +/- 1.28 (3.3-8.8) mg/dL. Mean Hb levels and percentage of anemic patients in each stages were 12.95 +/- 1.46 (10.5-15.4) g/dL, 0%; 13.31 +/- 2.20 (7.8-17.7) g/dL, 10.3%; 11.32 +/- 2.07 (7.4-16.6) g/ dL, 25.5%; 10.10 +/- 1.71 (6.7-14.0) g/dL, 54.8%; 9.21 +/- 1.53 (6.2-12.2) g/dL, 76.9%. The frequency of anemia were high in Diabeltes Mellitus (DM) compared to Non-Diabeltes (Non-DM) at stage 3, 4, 5 [36.7 vs 12.0% (p=0.06); 70.6 vs 35.7% (p=0.000); 100 vs 64.7 % (p=0.06)]. Multivariate logistic regression analysis revealed that DM as etiology (OR 2.53, p=0.033 compared with Non-DM), Albumin level (OR of 5.38, p= 0.001 for 3.0-1.4 compared with 4.0-5.3 g/dL) were independent factor determing anemia state in addition to K/DOQI guideline stage. GFR, sex, DM, Albumin level were independent factors associated with hemoglobin levels (R2=0.571, p<0.001). CONCLUSION: Anemia in CKD was developed relatively early and frequently at stage 3 (Cr, 1.69 +/- 0.36 mg/dL, 25.5%) and more aggravated as decreasing renal function (stage 4. 5; 54.8%, 76.9%). DM as underlying disease, hypoalbuminemia were, independently influenced Anemia development.
Anemia* ; Creatinine ; Dialysis* ; Hemodynamics ; Humans ; Hypoalbuminemia ; Kidney Diseases ; Korea ; Logistic Models ; Prevalence ; Renal Insufficiency, Chronic*

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

PURPOSE: The thickening of the gallbladder wall is a valuable finding for the diagnosis of cholecystitis, butmay be seen in non-cholecystic disease as well as in acute or chronic cholecystitis. The purpose of this study isto determine the value of color Doppler sonography in differentiating the causes of thickened gallbladder wall. MATERIALS AND METHODS: Ninety eight patients with thickened gallbladder wall(more than 3mm) which was not due to gallbladder cancer were prospectively evaluated with color Doppler sonography. Sixty-six cases, confirmed bypathologic reports and clinical records, were analyzed for correlation between thickened gallbladder wall andcolor flow signal according to the underlying causes. RESULTS: Of the 66 patients, 28 cases were cholecystitisand 38 cases had non-cholecystic causes such as liver cirrhosis, ascites, hepatitis, pancreatitis, renal failure,and hypoalbuminemia. Of the 28 patients with cholecystitis(12 acute, 16 chronic), 23(82%) had color Doppler flowsignals in the thickened gallbladder wall. Of the 38 patients with non-cholecystic causes, eight(21%) had color Doppler flow signals. There was a statistically significant difference of color Doppler flow signals between the cholecystitis and non-cholecystic groups(p=0.0001). No significant difference of color Doppler flow signals was found between cases of acute and chronic cholecystitis. Of the 23 patients with color Doppler flow signals in 28cases of cholecystitis, 18(78.3%) showed a linear pattern and five(21.7%) showed a spotty pattern. Of the eight patients with color Doppler flow signals in the 38 non-cholecystic cases, four(50%) showed a linear pattern andfour(50%) showed a spotty pattern. In cholecystitis, a linear color Doppler flow signal pattern is a much more frequent finding than a spotty pattern. CONCLUSION: Color Doppler sonography is a useful and adequate method for determining whether a thickened gallbladder wall is the result of cholecystitis or has non-cholecystic causes.
Ascites ; Cholecystitis ; Diagnosis ; Gallbladder* ; Hepatitis ; Humans ; Hypoalbuminemia ; Liver Cirrhosis ; Pancreatitis ; Prospective Studies