Acute and Critical Care

Case Report

Pulmonary
Successful Immunoglobulin Treatment in Severe Cryptogenic Organizing Pneumonia Caused by Dermatomyositis: Dong Hoon Lee, Jee Hyun Yeo, Young Il Kim, Seung Jun Gim, Jang Won Sohn, Ji Young Yhi; Korean J Crit Care Med. 2015;30(3):212-217. Published online August 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.3.212

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In connective tissue diseases, autoantibodies cause pulmonary interstitial inflammation and fibrosis, and patients require treatment with an immunosuppressive agent such as a steroid. Dermatomyositis is an incurable, uncommon form of connective tissue disease that occasionally causes diffuse pulmonary inflammation leading to acute severe respiratory failure. In such cases, the prognosis is very poor despite treatment with high-dose steroid. In the present case, a 46-year-old man was admitted to our hospital with dyspnea. He was diagnosed with dermatomyositis combined with cryptogenic organizing pneumonia (COP) with respiratory failure and underwent treatment with steroid and an immunosuppressive agent, but the COP was not improved. However, the respiratory failure did improve after treatment with intravenous immunoglobulin, which therefore can be considered a treatment option in cases where steroids and immunosuppressive agents are ineffective.

Citations

Citations to this article as recorded by

A Case Report of Steroid-Resistant Cryptogenic Organizing Pneumonia Managed with Intravenous Immunoglobulins
Christian Akem Dimala, Urvi Patel, Benjamin Lloyd, Anthony Donato, William B. Kimmel, Robert Hallowell, Caitlyn Moss, Tun-Chieh Chen
Case Reports in Pulmonology.2021; 2021: 1. CrossRef

Original Article

The S100B Protein Could Be Used as Adjuvant Diagnostic Tool in Acute Ischemic Stroke: Min Hee Jung, Dong Hoon Lee, Chan Woong Kim; Korean J Crit Care Med. 2011;26(4):217-220.; DOI: https://doi.org/10.4266/kjccm.2011.26.4.217

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Abstract PDF: BACKGROUND
In the emergency department, the diagnosis of ischemic stroke is difficult because the diagnostic modalities are limited to non-contrast brain CT and neurologic examination. Serum S100B protein, a bio-marker for ischemic stroke, is needed as an additional diagnostic aid in acute ischemic stroke.
METHODS
We retrospectively reviewed 50 patients diagnosed with ischemic stroke between August 2007 and December 2008 by brain MRI after brain CT and serum S100B measurement in the emergency department. The serum levels of S100B protein were analyzed and the diagnostic sensitivity of non-contrast brain CT combined with abnormal elevation of S100B protein was compared with that of non-contrast brain CT alone.
RESULTS
The overall sensitivity of non-contrast brain CT in the diagnosis of ischemia was 54%. S100B protein in early ischemia had a sensitivity of 58%. However, combining non-contrast brain CT and S100B increased the sensitivity to 74%.
CONCLUSIONS
A biomarker-based diagnostic test would not replace the necessity for CT or other early imaging studies, and before contemplating any reperfusion strategy, neuro-imaging must be performed to rule out intracranial hemorrhage. However, S100B protein, a serum bio-marker, is able to help emergency physicians evaluate patients with suspected ischemic stroke and decide on treatment.

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