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*

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

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

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

Systemic capillary leak syndrome(SCLS) is a rare disorder of unknown etiology, which is characterized by recurrent attacks of hypotension, hemoconcentration, and hypoalbuminemia. Urinary or enteric loss of protein is not demonstrated. It is often associated with monoclonal gammopathy, but does not manifest multiple myeloma. Since Clarkson et al. described the first case in a 34- year-old woman, about 50 cases have been reported in the literature. However, most of the cases were of adult age, and the mean age of onset in the reported cases was 42.6 years. In literature review, we could refer only one pediatric case of SCLC by Foeldvari et al. in 1995. We report another pediatric case of SCLS.
Adult ; Age of Onset ; Capillaries ; Capillary Leak Syndrome* ; Child* ; Female ; Humans ; Hypoalbuminemia ; Hypotension ; Multiple Myeloma ; Paraproteinemias

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

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

The causes of hypocalcemia in patients suffering from severe infection including sepsis are largely uncertain. So we measured serum albumin, total protein, cholesterol, PTH, and calcitonin of the infection-associated hypocalcemic children and compared with those of normocalcemic children suffering from tsutsugamushi disease. All had normal renal functions and had been admitted to the department of pediatrics of Gyeongsang National University Hospital. Hypocalcemic patients were hypoalbuminemic. Serum total calcium was inappropriately more decreased compared to the decreased amount of serum albumin in the hypocalcemic group. We also observed more frequent incidence of hypocholesterolemia (<100mg/dL) in this group. And serum PTH was appropriately elevated in the hypocalcemic patients. Serum calcitonin was elevated in both groups, but 6 times higher in the hypocalcemic group than in the normocalcemic one. Serum total calcium was positively correlated with serum albumin and negatively correlated with serum PTH and calcitonin.
Calcitonin ; Calcium ; Child ; Cholesterol ; Humans ; Hypoalbuminemia ; Hypocalcemia* ; Incidence ; Pediatrics ; Scrub Typhus ; Sepsis ; Serum Albumin