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*

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

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/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: 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*

Primary idiopathic polymyositis is a condition of presumed autoimmune etiology in which the skeletal muscle is damaged by a nonsuppurative inflammatory process dominated by lymphocytic infiltration. We recently experienced a patient with primary idiopathic Polymyositis associated with hypoalbuminemia and thrombocytopenia. About 4 months prior to admission, he was diagnosed as primary idiopathic polymyositis, and improved by treatment with prednisolone 60 mg/day. During steroid tapering, muscle weakness was recurred and accompanied by hypoalbuminemia and thrombocytopenia. Despite retreatment with prednisolone 60 mg/day, muscle weakness, hypoalbuminemia and thrombocytopenia persisted. He was then started to administer methotrexate(MTX) 15 mg/week which resulted in prompt improvement of muscle weakness, hypoalbuminemia and thrombocytopenia. These findnigs suggest that primary idiopathic polymyositis is one of the cause of hypoalbuminemia and thrombocytopenia, and that the hypoalbuminemia and thrombocytopenia can be improved promptly by methotrexate treatment.
Humans ; Hypoalbuminemia* ; Methotrexate ; Muscle Weakness ; Muscle, Skeletal ; Polymyositis* ; Prednisolone ; Retreatment ; Thrombocytopenia*

Eosinophilic gastroenteritis is a rare disorder of unknown origin that is pathologically characterized by marked infiltration of eosinophils in the wall of the gastrointestinal tracts. Eosinophilic gastroenteritis is often classified according to the layer of the bowel wall involved. We experienced two cases of eosinophilic gastroenteritis. One case having whole small bowel wall involvement resulting in small bowel obstruction and eosinophilic ascites underwent bowel resection followed by oral steroid treatment. The other case having mucosal layer involvement with chronic diarrhea and hypoalbuminemia was treated with oral corticosteroid and responded dramatically. In addition, we report one case of hypereosinophilic syndrome involving the gastrointestinal tracts. The patient presented with abdominal pain, ascites, and urticaria. and also showed good response to oral steroid.
Abdominal Pain ; Ascites ; Diarrhea ; Eosinophils* ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Hypereosinophilic Syndrome* ; Hypoalbuminemia ; Urticaria

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

Pseudomembranous colitis is mostly related to antibiotics and it presents symptoms of diarrhea, abdominal pain, fever, hypoalbuminemia and hypovolemia. Diarrhea is the most common manifestation, but in geriatric patients, symptoms of pseudomembranous colitis can be different from those of usual cases and the course of disease can be more aggressive. For these reasons, it can be misdiagnosed. So physicians must take pseudomembranous colitis into consideration in older patients with acute abdominal pain, who have been treated with antibiotics. We reported a case of an older patient with pseudomembranous colitis which was misdiagnosed as acute appendicitis with perforation.
Abdominal Pain ; Anti-Bacterial Agents ; Appendicitis ; Diarrhea ; Enterocolitis, Pseudomembranous ; Fever ; Humans ; Hypoalbuminemia ; Hypovolemia