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*

Primary intestinal lymphangiectasia is a congenital lymphatic disorder in which intestinal lymphatic channels are dilated and ruptured resulting in loss of protein, lipid, and lymphocyte into the intestine or peritoneum. As a result, hypoalbuminemia, generalized edema, diarrhea are clinically manifested. We report a case of primary intestinal lymphangiectasia with generalized edema which occurred in a 7-year old boy who was treated with lipid restriction diet with medium chain triglyceride oil supplement.
Child ; Diarrhea ; Diet ; Edema ; Humans ; Hypoalbuminemia ; Intestines ; Lymphocytes ; Male ; Peritoneum ; Protein-Losing Enteropathies ; Triglycerides

Pregnancy is rarely encountered in women with liver cirrhosis, but can occur in all forms of liver cirrhosis. The amount of data regarding pregnancy in cirrhotic patients is not great and thus no clear-cut guidelines for management can be outlined. Another interesting point of pregnancy in liver cirrhosis would be how pregnancy affects liver function in cirrhotic patients. In Korea, only 6 pregnancies in 5 patients have been reported. Recently, we experienced a case of pregnancy in a patient with liver cirrhosis. A 36 year-old, primigravida woman presented at 23 weeks of gestation. B-viral liver cirrhosis was diagnosed 2 months earlier when she had developed generalized edema and ascites. We observed a recovery of hyperbilirubinemia and hypoalbuminemia after a therapeutic termination of pregnancy. This case may illustrate that pregnancy can deteriorate liver function in some patients with liver cirrhosis. We report this case with an analysis of the reported cases in Korea.
Adult ; Ascites ; Edema ; Female ; Humans ; Hyperbilirubinemia ; Hypoalbuminemia ; Korea* ; Liver Cirrhosis* ; Liver* ; Pregnancy*

Intestinal lymphangiectasia, one of the protein-losing gastroenteropathies, is an uncommon disease characterized by dilated intestinal lymphatics, enteric protein loss, edema, hypoalbuminemia, and lympocytopenia. Small bowel biopsy and CT have been used to confirm the diagnosis of intestinal lymphangiectasia. Small bowel biopsy shows collections of abnormal dilated lacteals in submucosa with distortion of villi and CT findings have been described as diffuse nodular thickening of the small bowel and as linear hypodense streaking densities in the small bowel caused by dilated lymphatic channels. Demonstration of increased enteric protein loss using 51Cr-, 131I- or 99mTc-labeled albumin, timed measurement of fecal excretion of radioactivity or by measuring fecal clearance of alpha 1-antitrypsin can also help the diagnosis. We experienced a rare case of intestinal lymphangiectasia in an eight year old boy who presented with facial edema, abdominal distension and intermittent diarrhea. We report a patient with intestinal lymphangiectasia, in whom abdominal CT, 99mTc-labeled albumin scintitigraphy, and stool alpha 1-antitrypsin measurement played key roles in determining the diagnosis. A brief review of literature was made.
alpha 1-Antitrypsin ; Biopsy ; Diagnosis ; Diarrhea ; Edema ; Humans ; Hypoalbuminemia ; Male ; Radioactivity ; Tomography, X-Ray Computed

Primary intestinal lymphangiectasia is a congenital lymphatic disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein losing enteropathy. As a result, generalized edema, hypoalbuminemia, and lymphocytopenia are clinically manifested. We could not find the reason by several examinations. Therefore, we performed double balloon enteroscopy (DBE), and intestnal lymphangiectasia was diagnosed histologically by a biopsy. DBE is a safe and effective method to diagnose small bowel lymphangiectasia. We report a case of primary intestinal lymphangiectasia, which occurred in a 54-year-old male patient with generalized edema and ascites.
Ascites ; Biopsy ; Double-Balloon Enteroscopy ; Edema ; Humans ; Hypoalbuminemia ; Lymphopenia ; Male ; Protein-Losing Enteropathies

The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 mg/m2/hr), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.
Acalculous Cholecystitis* ; Anti-Bacterial Agents ; Edema ; Fluid Therapy ; Gallbladder ; Humans ; Hypoalbuminemia ; Nephrotic Syndrome* ; Suction

We reviewed 15 cases of necrotizing fascitis of the male genitalia. The clinical courses could be divided into two different types. In about one half of the patients the symptoms and signs progressed slowly within 122 weeks and in the remained they progressed rapidly. In the former, the prodromal signs were noted, usually low abdominal and inguinal pain. In 8 of fifteen patients, the locations of infectious focus were difficult to determine. The diagnosis were made after the development of scrotal necrosis in all of the cases. There were no differences in the causative pathogens comparing to 1hose of previous reports. The common underlying diseases were liver cirrhosis and diabetes. Hypoalbuminemia and leukocytosis were found in all. Of course, the strategy of treatment is same between two types, we would like to propose to use the term Fourier`s gangrene, a specific form of necrotizing fascitis, only to whose clinical course in acute and the location of primary infecious foci are obscure.
Diagnosis ; Fasciitis, Necrotizing* ; Gangrene ; Genitalia, Male* ; Humans ; Hypoalbuminemia ; Leukocytosis ; Liver Cirrhosis ; Male ; Male* ; Necrosis ; Prodromal Symptoms

We reviewed 15 cases of necrotizing fascitis of the male genitalia. The clinical courses could be divided into two different types. In about one half of the patients the symptoms and signs progressed slowly within 122 weeks and in the remained they progressed rapidly. In the former, the prodromal signs were noted, usually low abdominal and inguinal pain. In 8 of fifteen patients, the locations of infectious focus were difficult to determine. The diagnosis were made after the development of scrotal necrosis in all of the cases. There were no differences in the causative pathogens comparing to 1hose of previous reports. The common underlying diseases were liver cirrhosis and diabetes. Hypoalbuminemia and leukocytosis were found in all. Of course, the strategy of treatment is same between two types, we would like to propose to use the term Fourier`s gangrene, a specific form of necrotizing fascitis, only to whose clinical course in acute and the location of primary infecious foci are obscure.
Diagnosis ; Fasciitis, Necrotizing* ; Gangrene ; Genitalia, Male* ; Humans ; Hypoalbuminemia ; Leukocytosis ; Liver Cirrhosis ; Male ; Male* ; Necrosis ; Prodromal Symptoms

Subarachnoid hemorrhages (SAH) result in hemodynamic and metabolic abnormalities. The successful treatment of these abnormalities requires active treatment of neuroprotection. Recently, it has been known that albumin has important roles in neuroprotection as well as in hemodilution. We retrospectively studied 64 patients who were treated surgically for aneurysmal SAH to investigate the relationship between serum albumin levels, severity of disease and neurological outcomes. A high proportion of patients developed hypoalbuminemia after aneurysmal SAH. Patients with poor clinical presentation had significantly lower admission and postoperative albumin values than those with good clinical presentation. Comparison of patients with a favorable outcome and those with an unfavorable outcome revealed a significant difference in postoperative albumin values. In the patients with severe clinical presentation, postoperative albumin levels lower than 3.5 g/dL were associated with an unfavorable outcome. As a result of our analysis, albumin is an important prognostic factor in aneurysmal SAH. Therefore, active albumin replacement therapy might improve neurological outcomes as a neuroprotective agent. We therefore suggest that albumin offers great promise in the therapy of complications of SAH and we propose that it may now be appropriate to consider the initiation of early-phase clinical trials in patients with aneurymal SAH.
Aneurysm ; Hemodilution ; Hemodynamics ; Humans ; Hypoalbuminemia* ; Retrospective Studies ; Serum Albumin ; Subarachnoid Hemorrhage*