, Jin Hwa Lee, Sun Hee Sung, Seong Hoon Park Amiodarone has been widely used for supraventricular and ventricular arrhythmias and many patients benefit from its effectiveness in treating potentially life-threatening arrhythmias. However, this drug can cause multi-organ toxicity, including amiodarone-induced pulmonary toxicity (APT). Not only does amiodarone have a long half-life but also is lipophilic and therefore can easily accumulate in tissues. Hence, it is difficult to monitor therapeutic levels and side effects, making it difficult to predict toxicities. In this case, we describe multi-organ complications secondary to amiodarone use, especially APT combined with pneumonia with atypical pathogens and pulmonary hemorrhage. The patient reached a high cumulative dose of amiodarone despite a low maintenance dose of amiodarone. This case highlights an unusual presentation of APT with multi-organ toxicity and we review articles regarding the association between the cumulative dose of amiodarone and amiodarone-induced toxicities.
Citations
, Min-Young Choi, Soo-Hyun Kim, Eun Mi Song, Doo Hyun Baek, Ji Hye Kim, Yon Ju Ryu, Eun-Mi Chun, Jin Hwa Lee, Jung Hyun Chang, Sung Shine Shim Cryptococcal infections occur frequently in patients with cell-mediated immune deficiency, such as acquired immune deficiency syndrome, organ transplants, hematologic malignancy patients and immunocompromised patients who receiving cancer chemotherapy or corticosteroid therapy. In these conditions, cryptococcosis can cause serious infections requiring systemic antifungal therapy such as meningoencephalitis and sepsis. However, pulmonary cryptococcosis in immunocompetent hosts may have self-limited course and improve without treatment. We experienced various pulmonary manifestations of pulmonary cryptococcosis in five immunocompetent patients. We diagnosed three cases of isolated pulmonary cryptococcosis and two cases of disseminated cryptococcosis involving lungs. All cases were treated with intravenous injection of amphotericin B during hostpital care, and maintained with oral fluconazole after discharge. During the follow-up, clinical symptoms and radiologic features were markedly improved.
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, Yon Ju Ryu, Hye Won Kang, Doo Hyun Baek, Soo Hyun Kim, Min Young Choi, Hye Sung Park, Jin Hwa Lee, Eun-Mi Chun, Jung Hyun Chang, Young Joo Cho, Yoon Hee Jun, Sung Shine Shim, Miae Lee , Hye Jung Chang, Min Jung Kang, Ji Young Oh, In Je Kim, Yun Su Sim, Jin Wook Moon, Jung Hyun Chang, Jin Hwa Lee, Sun Hee Sung Acute eosinophilic pneumonia is characterized by acute febrile disease with diffuse interstitial infiltration on chest radiography, eosinophilic infiltration of lung parenchyma on lung biopsy and good response at corticosteroid therapy. There has been several reports that support cigarette smoking recently, even though the pathogenesis is not clear. We encountered a case of acute eosinophilic pneumonia induced by cigarette smoking, who, being a 20-year-old man, presented with acute onset of fever after his first cigarette smoking. His clinical symptoms and the infiltrations on onset x-ray improved after a treatment with corticosteroid.
, Hye Jung Chang, Ji Min Jung, Min Jung Kang, Ji Young Oh, Eun Hwa Choi, Moon Young Choi, Jin Wook Moon, Jung Hyun Chang, Jin Hwa Lee, Woon Sup Han Dieulafoy's disease is the vascular anomaly characterized by the presence of arteries of persistent large caliber in the submucosa, and in some instances, the mucosa, typically with a small, overlying mucosal defect. Only a few cases of this lesion occuring in the bronchial system have been reported to date. The etiology of Dieulafoy's disease is still unclear, but chronic bronchial injury and/or congenital vascular malformation have been postulated. We encountered a case of bronchial Dieulafoy's disease that developed in a 69-year-old woman who had been treated for pulmonary tuberculosis for 4 months. Her chief complaint was hemoptysis and the bronchoscopic finding showed an intrabronchial protruding lesion produced by the arteries beneath the bronchial mucosa of the anterior segment of right upper lobe. She has been well after the surgical resection of right upper lobe.
Citations
, Jin Hwa Lee, Sook Hui Kim, Hyang Woon Lee Women with epilepsy(WWE) are at risk for reproductive and metabolic disorders. This study was performed to investifate whether WWE are more likely to have menstual or metabolic abnormalities, and whether some antiepileptic drugs(AEDs) more likely provoke those problems.
WWW aged 15-50 years old, taking one or more AEDs for at least 6 months, were recruited. Subjucts checked their oral temperature each morning. Body mass index(BMI : kg/m2) and waist to hip (W/H) ratio were calculated as obesity markers. Hirsutism index, as a marker of polycystic ovary syndrome, was calculated by Ferriman-Gallwey score(hirsutism if score>8). Serum tests ofr gonadotrophins, steroid hormones, sex hormone binding globulins (SHBG), lipid profiles, insulin were performed on menstrual cycle days 3 to 5.
Among 54 patients, 18 women were diagnosed as primary generalized epilepsy(PGE) and the other 36 were localoization-related epilepsy(LRE). Also, 21 women(38.9%) were treated with carbamazepine(CBZ), 14 women(25.9%) with valproate(VPA), and 19(35.2%) with lamotrigine(LTG) or topiramate(TPM). Menstrual disturbance was found in 60.0% of PGE versus 30.6% of LRE patients(p=0.050), while 64.3% of VPA and 28.6% of CBZ-treated patients(
WWE are more likely to experience menstrual and metabolic alterations. WWE with VPA tend to have abdominal obesity and alterations in lipid metabolism.
, You Kyoung Cho, Hyun Ju Song, Hyun Kyung Lee, Jin Hwa Lee, Sun Hee Sung, Yoo-kyung Kim, Jung Hyun Chang Primary ciliary dyskinesia is a genetic disorder of abnormal ciliary structure and function that leads to defective mucociliary clearance, resulting in sinopulmonary infection and infertility. Kartagener's syndrome is a subclass of primary ciliary dyskinesia and which is clinically distinguishable by the presence of situs inversus. Electron microscopy of cilia reveals ultrastructural defects in the ciliary axoneme. In the respiratory tract, this inability presumably causes impaired clearance of mucus and inhaled particles and results in the chronic infections of sinuses and bronchial trees that are characterized of the disease. Early diagnosis of the disease may be important for prevention of bronchiectasis and pulmonary insufficiency.
We report one case of primary ciliary dyskinesia associated with Kartagener's syndrome in a 14 year-old young man who was presented as bronchiectasis, chronic and situs inversus, with review of literature.
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