, Mi Seung Shin, Duk Hee Kang, Gue Bock Choi, Kyun Il Youn The adult polycystic kidney disease(APCK) is inheritant disease in which cysts aredistributed throught the cortex and medulla of both kidneys. The disease process is usually notclinically apparent until the third or fourh decade of life. Mild persistent proteinuria(> 200mg/d) can be developed in 20% to 40% of cases, but nephrotic-range proteinuria is rare and whenfound, should prompt a search for the other concomitant renal disorder, such as IgA nephropathy, rapidly progressive glomerulonephropathy, focal glomerulosclerosis.
We report a case of APCK presented with nephrotic syndrome. A 76-year-old man was admitted due to generalized edema with weakness. The blood pressure was120/80mmHg. The BUN/creatinine were 15/1.2mg/dl, serum albumin 2.9g/dl, cholesterol / triglyceride 432/273mg/dl, total urinary protein excretion 8.41g/day.
The serum level of IgG, IgAS, IgM, C3, C4 were within normal range and anti-nuclear antibody and anti-double strand DNA antibody were also negative. The abdominal ultrasonography and computerized tomography revealed multiple large cysts in both kidneys.The patient was treated with Enalapril®, an angiotensin converting enzyme inhibitors, 5mg forcontrol of proteinuria.
The APCK presented with nephrotic syndrome is rare and to our knowledge,this is a first report in Korea.
, Hee Jin Kim, Duk Hee Kang, Soon Nam Lee, Bong Suck Shim, Kyong Ja Lee Priapism is the pathologic prolongation of a penile erection most often associated with pain but not with sexual excitement or desire. Recently we experienced one case of priapism accompained by chromic myelocytic leukemia.
For treatment of priapism, cavernososponsiosal shunt, radiotherapy and chemotherapy with hydroxyurea were done.
, In Jeong Cho, Seung Hyun Yoo, Mina Yu, Dong Ryeol Ryu, Seung Jung Kim, Duk Hee Kang, Kyu Bok Choi, Kyun Il Yoon, Sun Hee Sung A unique type of rapidly progressive interstitial fibrosis of the kidney, the Chinese Herb Nephropathy (CHN) has been reported in Belgian woman after intake of Chinese herbs. CHN contains several characteristics that include variable clinical features from progressive renal failure to Fanconi's syndrome, histologic finding of extensive interstitial fibrosis, high risk of urothelial malignancy. We are reporting a case of33 year-old female patient who was diagnosed as CHN. The patient visited our hospital with symptoms of nausea. Laboratory investigation showed metabolic acidosis with normal anion gap, hypokalemia, hypophosphatemia, proteinuria, glycosuria consistent with Fanconi's syndrome. She took Chinese herbs for slimming 4 months before. Renal biopsy showed the features of tubular cell injury with interstitial edema, accompanied by interstitial fibrosis on following biopsy, compatible with Chinese Herb Nephropathy. After 5 months, her renal function was progressed rapidly, therefore peritoneal dialysis was started. This case shows that we should consider Chinese herb as a cause of renal failure.
Citations
, Jae Hun Kim, Sung Jae Park, Dong Won Byun, Duk Hee Kang, Bong Suk Shim Renal cell carcinoma can presents wide range of signs and symptoms, and commonly associated with paraneoplastic syndrome. Paraneoplastic manifestations are present in up to 20% of patients with renal cell carcinoma. There is convincing evidence that renal cell carcinoma tumor cells elaborate proteins that serve as mediators of endocrine (ex ; ectopic production of parathyroid hormone-related protein or erythropoietin) as well as nonendocrine paraneoplastic syndromes. A paraneoplastic syndrome may be the various clinical presentation of renal cell carcinoma in a significant number of patients, therefore mimicked other general disease. We report a case of renal cell carcinoma associated with paraneoplastic syndrome mimicking pyelonephritis.
, Gyu Bock Choi, Duk Hee Kang, Kyun Il Yoon Acute bilateral renal cortical necrosis is a rare cause of acute reanl failure, occuring in about 2% of patients and it's prognosis is fatal. The pathophysiology of this condition is complex, but ultimately leads to the destruction of the renal cortex with sparing of the renal medulla and a thin tissue rim of under the capsule.
In this report we describe a 23-year-old female patient in whom the diagnosis was made using MR imaging during the acute initial phase of the disease. On T1-weighted images, the signal intensity of the renal cortex was increased, but the signal intensity of the renal cortex was demarcated by a rim of low signal intensity in the region of the corticomedullary junction. MR imaging is useful, noninvasive, and specific modality for an early diagnosis of acute bilateral renal cortical necrosis.
, Duk Hee Kang, Gyu Bok Choi, Kyun Ill Yoon Patients undergoing maintenance hemodialysis(HD) potentially have an increased risk of exposure to viral hepatitis. The reported prevalence of antiHCV in hemodialysis patients varied widely form 7.6-54% according to dialysis center and there were there were many reports that showed the correlation between the prevalence of antiHCV and duration of HD or transfusion amount.
Fifty-four patients on regular hemodialysis at our hospital were evaluated for the presence of hepatitic C antibody(antiHCV) with the comparison of various parameters such as duration of HD, amount of transfusion, past history of hepatitis, serologic markers of hepatitis B and current liver function. AntiHCV using second-generation enzyme linked immunosorbant assay were found in six of 54HD patients(11.1%). Among six antiHCV(+) percent four patients were found to have HCV-RNA in their plasma detected by PCR. The percent of male patients were significantly higher in antiHCV(+) group(66.7 vs 31.3%, p<0.05). The positivity of antiHCV did not correlated with the duration of HD and amount of transfusion(p>0.05), but prevalence increased over 2 years (5.9% in 1991, 11.1% in 1993) and HBsAg prevalence remained unchanged(9.8% in 1991, 9.3% in 1993).
Therefore, regular follow-up of liver function test and use of separate machine for antiHCV positive patients may be needed to prevent the transmission of the hepatitis C virus during the hemodialysis process itself.
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