천식환자에서 병발된 S 단백 결핍과 연관된 폐동맥 색전증 1예
Pulmonary Thromboembolism Associated with Protein S Deficiency in a Patient with Difficult-to-Control Asthma
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Asthma is a chronic multifactorial disease with frequent exacerbations in many patients. Much effort has been made to determine prevalent factors associated with difficult- to-control asthma. Here we report the case of a 57-year-old man who was treated for asthma during the last 4 years at our pulmonology clinic. Recently, the patient experienced severe dyspnea for more than 3 months despite the addition of the leukotriene modifier, theophylline and oral cortic-osteroid. Chest CT scans revealed multifocal areas of pulmonary arterial thrombosis. Doppler ultrasonograms showed multiple deep vein thrombi. The patient was diagnosed of having protein S deficiency and was treated with low molecular weight heparin, followed by oral warfarin. Now, he has no pulmonary arterial thrombosis and has no more asthmatic attack for half a year.
Abstract
Asthma is a chronic multifactorial disease with frequent exacerbations in many patients. Much effort has been made to determine prevalent factors associated with difficult- to-control asthma. Here we report the case of a 57-year-old man who was treated for asthma during the last 4 years at our pulmonology clinic. Recently, the patient experienced severe dyspnea for more than 3 months despite the addition of the leukotriene modifier, theophylline and oral cortic-osteroid. Chest CT scans revealed multifocal areas of pulmonary arterial thrombosis. Doppler ultrasonograms showed multiple deep vein thrombi. The patient was diagnosed of having protein S deficiency and was treated with low molecular weight heparin, followed by oral warfarin. Now, he has no pulmonary arterial thrombosis and has no more asthmatic attack for half a year.
참고문헌 (13)
- Cembrzynska-Nowak M, "Elevated release of tumor necrosis factor-alpha and interferon-gamma by bronchoalveolar leukocytes from patients with bronchial asthma", Am Rev Respir Dis, 147, pp.291~5 (1993)
- Barnes PJ, "Difficult asthma", Eur Respir J, 12, pp.1209~18 (1998)
- Fahy J, "Proceedings of the ATS workshop on refractory asthma: current understanding, recommendations, and unanswered questions. American Thoracic Society", Am J Respir Crit Care Med, 162, pp.2341~51 (2000)
- The ENFUMOSA Study Group, "The ENFUMOSA cross-sectional European multicentre study of the clinical phenotype of chronic severe asthma", Eur Respir J, 22, pp.470~7 (2003)
- 김윤근, "기관지천식의 명역학적 병인에 선천면역의 역할", 천식 및 알레르기, 24(2), pp.169~175 (2004), 대한천식알레르기학회
- 권순석, "천식 지침서의 순응도", 천식 및 알레르기, 26(4), pp.269~270 (2006), 대한천식알레르기학회
- Araujo AC, "Investigation of factors associated with difficult-to-control asthma", J Bras Pneumol, 33, pp.495~501 (2007)
- Lamblin C, "Bronchial neutrophilia in patients with noninfectious status asthmaticus", Am J Respir Crit Care Med, 157, pp.394~402 (1998)
- Eidelman O, "Control of the proinflammatory state in cystic fibrosis lung epithelial cells by genes from the TNF-alphaR", NFkappaB pathway, 2001, pp.7, 523~34
- van Aken BE, "Interleukin 8 and venous thrombosis: evidence for a role of inflammation in thrombosis", Br J Haematol, 116, pp.173~7 (2002)
- Luster AD, "Chemokines--chemotactic cytokines that mediate inflammation", N Engl J Med, 338, pp.436~45 (1998)
- Divac A, "Nagorni-Obradovic LJ, Nikolic A, et al. Recurrent pulmonary embolism in a patient with asthma", Respiration, 71, pp.428~ (2004)
- Reid DW, "Possible anti-inflammatory effect of salmeterol against interleukin-8 and neutrophil activation in asthma in vivo", Eur Respir J, 21, pp.994~9 (2003)