, Gyu Bog Choi, Kyun Ill Yoon We evaluated the clinical manifestations, laboratory findings including renal biopsies and treatments in 30 cases of lupus nephritis who were seen between jan., 1981 to Dec., 1991 in Ewha Womans University Hospital.
The results were as follows:
1) Among 72 patients. 11 cases were men and 61 were women(M:F=1:5.5). The onset of disease were developed between 2nd and 3rd decades in 76% of cases. Their median age was 26.9 years.
2) The study of ARA criteria for SLE showed that the incidence of the renal disease was 81.8%, anemia 50% and antinuclear antibody(ANA) 77.3%.
3) At the time of the diagnosis. among 30 patients with lupus nephritis. 25% of patients had serum creatinine over 1.2mg/dl and 25% had proteiuria over 3.5g/day.
4) According to the WHO classification. 12 patients(66%) belonged to class IV and 2 patients(11.1 %) to class III. Among patients classified as class IV. the 33% showed nephrotic syndrome and 66.7% had serum creatinine over 1.2mg/dl.
5) At the time of the diagnosis, among 30 patients with lupus nephritis. the incidence of anti-DNA antibody was 66.7%. decreased C3 titer was 73.3 % and decreased C4 titer was 76.7%.
6) Among 18 patients with oral prednisolone alone, the rate of complete remission was 11.1% and deterioration including death was 33.3%. Among 7 patients with prednisolone plus cyclophophamide. the rate of complete remission was 14.3% and deterioration including death was 28.8%.
7) Among 30 patients with lupus nephritis. 6 patients died. Most common cause of death was cardiovascular disease with 3 cases, followed by infection, 2 cases and renal failure, 1 case.
, Kyun Il Yoon Since its first introduction by Popovich in 1976. Continuous Ambulatory Peritoneal Dialysis(CAPD) has estabilished itself as an effective method maintaining the patients with end stage renal disease. But recurrent peritonitis remains the most frequent cause of the CAPD failure. So clinical studies were carried on the 15 patients on CAPD who had been treated from June 1989 to march 1991.
The following results were obtained.
1) The incidence of peritonitis was 1.73 episode/patient/year.
2) Peritonitis incidence according to the sex showed 1.93 episode/patient/year with female patients and l.46 episode/patient/year with male patients.
3) Peritonitis incidence according to the underlying disease showed 1.94 episode/patient/year with diabetic patients and 1.45 episode/patient/year with non-diabetic patients.
4) The subjective symptom and sign were as follows; abdominal pain(95%). cloudy dialysate(95%). nausea(55%), abdominal tenderness(95%). decreased dialysate drainage (59%), fever(50%), and peripheral leukocytosis(18%).
5) The positive rate in Gram stain of dialysate drainage fluid was 13.6% and the positive rate in culture was 31.8%. of which staphylococcus was 42.9%.
6) The rate of catheter removal due to peritonitis was 22.7%. The most common cause was persistent peritonitis, which accounted for 60% of cases. And all cases of catheter removal were developed in female patients.
7) The complications related to catheter were as follows ; catheter exit site infection(20%), external cuff extrusion(20%), leakage of dialysate fluid(6.7%) and crack on Tenckhoff catheter(6.7%)
, Gyu Bog Choi, Kyun Il Yoon A patient with severe active systemic lupus erythematosus, who had not responded to conventional therapy, was treated with plasmapheresis and subsequent pulse cyclophosphamide. There was the reduction of anti-ds DNA level was deteced after plasmapheresis in conjunction with the immunosuppressive therapy could be and effective modality of management in patients with rapidly deteriorating SLE who are responding inadequately to the conventional therapy.
, Kyung Sook Han, Woon Joo Bae, Mi Kyung Kim, Soon Nam Lee, Nan Hoo Kyung Gilbert's Syndrome is the name most frequently used to describe a condition which has been called constitutional heptic dysfunction, familial nonhemolytic jaundice of icterus intermittens juvenilis. It is characterized by a benign, persistent, but variable elevation of the plasma unconjugated bilirubin. A 27-year-old man was admitted because of general malaise, anorexia, sore throat and slight icteric sclera. On physical examination, there were mild icteric sclera and slightly injected pharynx. The liver was palpable 1 finger breath BRCM and the spleen was also palpable I finger breadth BLCM. Hematologic studies revealed slight anemia with slightly elevated corrected reticulocyte count. Liver function tests were normal except for slightly elevated serum total bilirbin. Histolog-ic findings of the liver showed nonspecific findings of mild cholestasis. Reduction in caloric intake to 300 calrory a day for 72 hours resulted in a significant increase in the plasma bilirubin concentration(especially unconjugated form) in this patient. Now he has no subjective symptoms and leads a normal activity without specific treatment.
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