2.Isolated Right Pulmonary Artery Hypoplasia with Retrograde Blood Flow in a 68-Year Old Man.
Youjin CHANG ; Seung Won RA ; Eun Jin CHAE ; Joon Beom SEO ; Won Young KIM ; Shin NA ; Joo Hee KIM ; Tai Sun PARK ; Soo Kyung PARK ; Seong Joon PARK ; Taehoon LEE ; Young Chel AHN ; Sang Do LEE
Tuberculosis and Respiratory Diseases 2011;71(2):126-133
Unilateral pulmonary artery hypoplasia (UPAH) is a rare disease in adults and is frequently accompanied by a congenital cardiac anomaly at a young age. The diagnosis is usually based on computed tomography (CT), angiography, and magnetic resonance imaging (MRI). However, no reports are available on retrograde flow in patients with UPAH. We describe a 68-year-old man with isolated UPAH and retrograde blood flow. He was admitted for dyspnea on exertion for the past 23 years. His diagnosis was delayed, as his symptoms and signs mimicked his underlying pulmonary diseases, such as emphysema and previous tuberculous pleurisy sequelae. A discrepancy was detected between the results of a ventilation-perfusion scan and the CT image. This was resolved by MRI, which showed retrograde blood flow from the right to the left pulmonary artery. Using MRI, we diagnosed this patient with isolated pulmonary artery hypoplasia and retrograde flow.
Adult
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Aged
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Angiography
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Dyspnea
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Emphysema
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Humans
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Lung Diseases
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Magnetic Resonance Imaging
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Pulmonary Artery
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Rare Diseases
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Regional Blood Flow
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Tuberculosis, Pleural
3.Bortezomib Treatment for Refractory Antibody-Mediated Rejection Superimposed with BK Virus-Associated Nephropathy during the Progression of Recurrent C3 Glomerulonephritis.
Wonseok DO ; Jong Hak LEE ; Kyung Joo KIM ; Man Hoon HAN ; Hee Yeon JUNG ; Ji Young CHOI ; Sun Hee PARK ; Yong Lim KIM ; Chan Duck KIM ; Jang Hee CHO ; Youngae YANG ; Minjung KIM ; Inryang HWANG ; Kyu Yeun KIM ; Taehoon YIM ; Yong Jin KIM
The Journal of the Korean Society for Transplantation 2018;32(3):57-62
A 38-year-old man, who underwent a second kidney transplantation (KT), was admitted because of antibody-mediated rejection (AMR) complicated by BK virus-associated nephropathy (BKVAN). He was placed on hemodialysis at the age of 24 years because of membranoproliferative glomerulonephritis. At the age of 28 years, he underwent a living donor KT from his father; however, 1 year after the transplantation, he developed a recurrence of the primary glomerular disease, resulting in graft failure 2 years after the first KT. Ten years later, he received a deceased-donor kidney with a B-cell-positive-cross-match. He received 600 mg of rituximab before the KT with three cycles of plasmapheresis and immunoglobulin (0.5 g/kg) therapy after KT. During the follow-up, the first and second allograft biopsies at 4 and 10 months after KT revealed AMR with a recurrence of primary glomerular disease that was reclassified as C3 glomerulonephritis (C3GN). He received a steroid pulse, rituximab, plasmapheresis, and immunoglobulin therapies. The third allograft biopsy demonstrated that the BKVAN was complicated with AMR and C3GN. As the azotemia did not improve after repeated conventional therapies for AMR, one cycle of bortezomib (1.3 mg/m²×4 doses) was administered. The allograft function stabilized, and BK viremia became undetectable after 6 months. The present case suggests that bortezomib therapy may be applicable to patients with refractory AMR, even in cases complicated with BKVAN.
Adult
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Allografts
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Azotemia
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Biopsy
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BK Virus
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Bortezomib*
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Fathers
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Follow-Up Studies
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Glomerulonephritis*
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Glomerulonephritis, Membranoproliferative
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Graft Rejection
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Humans
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Immunization, Passive
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Immunoglobulins
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Kidney
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Kidney Transplantation
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Living Donors
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Plasmapheresis
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Recurrence
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Renal Dialysis
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Rituximab
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Transplants
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Viremia