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*

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

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

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

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

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

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

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

BACKGROUND/AIMS: Leukocytosis and hypoalbuminemia are known to be poor prognostic factors. The aim of this study was to determine how the leukocyte counts and albumin level are related to the colonic endoscopic findings. METHODS: Fifty three pseudomembranous colitis (PMC) patients confirmed by a lower endoscopy were analyzed. Endoscopic degree of pseudomembranous plaque was classified into four grades. The endoscopic severity was classified into two groups (group A: G I~II, group B: G III~IV). RESULTS: The mean age was 64.9 years, the mean onset of diarrhea after exposure to antibiotics was 12.9 days, the reasons for admission were medical (58.5%, 31) and surgical (41.5%, 22). Frequently the causative antibiotic was cephalosporin (81.1%, 43/53), and the mean WBC counts and albumin level were 13,045/mm3 and 3.13 g/dL, respectively. The endoscopic degrees of PMC was grade I (9.4%, 5), grade II (32.1%, 17), grade III (41.5%, 22), and grade IV (17%, 9). The patients' WBC counts and albumin level were not associated with the endoscopic severity. The age, gender, causative antibiotics, diabetes showed no correlation. CONCLUSIONS: There were no correlations between the known poor clinical prognostic factors (leukocystosis and hypoalbuminemia) and the endoscopic severity.
Anti-Bacterial Agents ; Colitis* ; Colon ; Diarrhea ; Endoscopy ; Enterocolitis, Pseudomembranous ; Humans ; Hypoalbuminemia ; Leukocyte Count ; Leukocytosis