성인 신증후군 환자에서 합병된 원발성 세균성 복막염 2예
Two cases of spontaneous bacterial peritonitis in adults with nephrotic syndrome
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초록
저자들은 신증후군을 진단 받은 성인에서 스테로이드 치료 도중에 원발성 세균성 복막염이 합병되어 항생제 치료로 호전된 2예를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. 향후 신증후군의 조직학적 진단에 따른 빈도, 원인 균주, 발병의 위험인자, 정확한 발병원인 등에 대한 연구가 더 진행되어야 할 것이다.
Abstract
Spontaneous bacterial peritonitis is one of the important complication of childhood nephrotic syndrome which occurs not infrequently but this complication in adults with nephrotic syndrome is ,however, very rare. The fact that ascites formation is more frequently seen in childhood nephrotic syndrome and that minimal change disease, the commonest pathology found in childhood is associated with impairment in both cellular and humoral immunities may be an explanation for the discrepancy. We have experienced two cases of spontaneous bacterial peritonitis complicated in adults with nephrotic syndrome. The age of patients is 23 and 68 years respectively. The serum IgG level of younger patient is markedly decreased (375 mg/dL) and that of elderly patient is lower normal limit (765 mg/dL). Peritonitis was complicated during relapse in the younger patient. Both of the patients were receiving steroid therapy before complicated by peritonitis. Both patients recovered from peritonitis by antibiotic therapy but, elderly patient died from nosocomial pneumonia.(Korean J Med 62:302-306, 2002)