Search

Background and aims This study was performed to identify the prevalence and risk factors that are associated with neutropenia in Korean patients with systemic lupus erythematosus (SLE). Methods A total 160 admissions of 85 SLE patients between 2006 and 2013 were retrospectively reviewed. Neutropenia was defined as absolute neutrophil count (ANC) below 1500/mm3. Baseline characteristics of the patients were compared between patients who experienced neutropenia and those without. Clinical and serological factors related to neutropenia episode during admission were analysed. Results Thirty two (37.6%) patients experienced neutropenia, and neutropenia episode was found in 35 (21.9%) of admissions. Most of the neutropenia episodes were mild to moderate. Severe neutropenia of ANC Conclusions This study demonstrates that most of neutropenia in SLE patients occur as part of hematologic and immunologic abnormalities. SLE patients with renal damage and Sjogren’s syndrome should be closely monitored for development of neutropenia.

Background Hematologic manifestations are common in systemic lupus erythematosus (SLE). Lymphopenia is most commonly found among leukopenia, but neutropenia is also found in about 50–60% of SLE patients. Most patients experience mild neutropenia while less than 5% of those experience moderate to severe neutropenia which can increase susceptibility to recurrent infection. Although it is crucial to understand risk factors associated with neutropenia in SLE patients, there is a paucity of clinical data regarding neutropenia in patients with SLE. Objectives This study was performed to identify the clinical and serologic factors that are associated with neutropenia in patients with systemic lupus erythematosus (SLE). Methods A total 160 admissions of 85 SLE patients between 2006 and 2013 were retrospectively reviewed. Neutropenia was defined as absolute neutrophil count (ANC) below 1,500/mm 3 . Baseline characteristics of the patients were compared between patients who experienced neutropenia and those without. Clinical and serological factors related to neutropenia episode during admission were analyzed using generalized estimating equation (GEE) and multivariate analysis. Results Thirty two (37.6%) patients experienced neutropenia, and neutropenia episode was found in 35 (21.9%) of admissions. Most of the neutropenia episodes were mild to moderate. Severe neutropenia of ANC 3 occurred in 14.3% of the cases. Patients with neutropenia had higher frequencies of ANA (100.0 vs 86.8%, P =0.042) and anti-dsDNA (87.5 vs 60.4%, P =0.008), and satisfied more SLE classification criteria at the time of the diagnosis than those without (4.8 vs 4.1, P =0.014) Clinical characteristics at admission such as comorbidities, concomitant medications, and SLEDAI were not different between admissions with and without neutropenia episode. Anemia, leukopenia, thrombocytopenia and low complement levels were frequently associated with neutropenic episodes. Co-existence of chronic kidney disease (OR,16.91; 95% confidence interval (CI), 2.09–136.6; P =0.008) and Sjogren9s syndrome (OR, 6.48; 95% CI, 1.46–28.66; P =0.014) was associated with increased risk of developing neutropenia. Conclusions This study demonstrates that most of neutropenia in SLE patients occur as part of hematologic and immunologic abnormalities. SLE patients with renal damage and Sjogren9s syndrome should be closely monitored for development of neutropenia. Disclosure of Interest None declared

Autoimmune pancreatitis (AIP) has two distinct subsets. Type 1 AIP or lymphoplasmacytic sclerosing pancreatitis is systemic disease with the elevation in serum levels of the IgG4. Type 2 AIP, also called duct-centric pancreatitis, features granulocyte epithelial lesions with duct obstruction in the pancreas without systemic involvement. Here, we report a case of type 2 AIP diagnosed by pathology, which is the first report in Korea. The case is a 56-year-old woman who presented with anorexia and vomiting. Computed tomography revealed mass-like lesion in the pancreatic head and the compression of the distal common bile duct and the head portion of the main pancreatic duct. Serum levels of the IgG4 were normal. Histologic examination revealed a dense neutrophil infiltration in the pancreatic parenchyme associated with extensive fibrosis, thereby confirming the diagnosis of type 2 AIP. The abnormalities in the clinical, laboratory, and radiological findings improved after oral steroid treatment.

This study was designed to evaluate the clinical features of abdominal actinomycosis and to assess its therapeutic outcome. We reviewed patients with abdominal actinomycosis in Seoul St. Mary hospital, between January 1994 and January 2010. Twenty-three patients (5 male and 18 female, mean age, 47.8 yr; range, 6-75 yr), with abdominal actinomycosis were included. Emergency surgery was performed in 50% due to symptoms of peritonitis. The common presentation on preoperative computerized tomography was a mass with abscess, mimicking malignancy. The mean tumor size was 7.0 cm (range, 2.5-10.5). In all patients, actinomycotic masses were surgically removed. Mean duration of hospital stay was 17.8 days (range, 5-49). Long term oral antibiotic treatment (mean 4.2 months; range, 0.5-7.0 months) were administered to all patients. All patients were free of recurrence after a median follow up of 30.0 months (mean 35.5 ± 14.8 months, range, 10.0-70.0 months); recurrence was not seen in any patient. In conclusion, abdominal actinomycosis should be included as a differential diagnosis when an unusual abdominal mass or abscess presents on abdominal CT. Assertive removal of necrotic tissue with surgical drainage and long term antibiotic treatment provide a good prognosis in patients with actinomycosis.

Chronic expanding hematoma of the thorax is a specific subtype of the chronic empyema. It presents as a slowly expanding intrathoracic mass which result in dyspnea or recurrent hemoptysis. The symptoms develop months or years after tuberculous pleurisy, trauma or surgery. Usually, it shows three common findings: a giant mass lesion in the thorax, some surrounding calcifications, the absence of signs or symptoms of infection. We report a case of chronic expanding hematoma of the thorax, initially presenting as massive hemoptysis through bronchopleural fistula which resulted in radiologic findings of new air-fluid level within the previous pleural lesion filled with unknown materials.

ARA-C에 의한 피부 부작용으로 나타나는 스티븐스존슨증후군은 드물지만 사망률이 높은 심각한 질환이다. 현재까지 보고된 ARA-C에 의한 스티븐스존슨증후군, 또는 독성표피괴사융해는 적절한 치료에도 불구하고 증상 악화로 사망하였다. 본 증례에서 저자들은 국내에서 처음으로 스테로이드 점적 주사로 증상 호전을 보인, ARA-C에 의한 스티븐스존슨증후군을 경험하여 문헌 고찰과 함께 보고하는 바이다