The Korean Journal of Medicine

  • 제79권4호
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  • Pages.412-416
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  • 2010
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지

Churg-Strauss 증후군 환자에서 발생한 무결석 담낭염

Acalculous cholecystitis in a patient with Churg-Strauss syndrome

  • 박종환 (부산대학교병원 소화기내과) ;
  • 강대환 (부산대학교병원 소화기내과) ;
  • 이진호 (부산대학교병원 소화기내과) ;
  • 김민대 (부산대학교병원 소화기내과) ;
  • 최철웅 (부산대학교병원 소화기내과) ;
  • 김형욱 (부산대학교병원 소화기내과)
  • Park, Jong-Hwan (Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute) ;
  • Kang, Dae-Hwan (Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute) ;
  • Lee, Jin-Ho (Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute) ;
  • Kim, Min-Dae (Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute) ;
  • Choi, Cheol-Woong (Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute) ;
  • Kim, Hyung-Wook (Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute)
  • 투고 : 2009.08.21
  • 심사 : 2009.09.25
  • 발행 : 2010.10.01
⟨ 이전 논문 다음 논문 ⟩

초록

저자들은 급성 무결석성 담낭염으로 발현한 Churg-Strauss 증후군 환자를 조직 소견을 포함한 ACR 기준에 따라 진단하여 치료하였고, 증상 호전 후 담낭절제술을 시행하였는데 담낭조직에서는 호산구 침윤이나 혈관염을 찾을 수 없었던 증례를 경험하여 관련 문헌 및 최근 문헌보고와 함께 보고하는 바이다.

Churg-Strauss syndrome is an uncommon disorder characterized by asthma, hypereosinophilia, and systemic vasculitis. Gastrointestinal involvement is commonly encountered in Churg-Strauss syndrome; however, acute cholecystitis is rare, and few cases have been documented in the literature. A 22-year-old female with a history of asthma was admitted with a complaint of steady pain in the right upper abdominal quadrant. Laboratory test results showed leukocytosis with hypereosinophilia. Abdominal ultrasonography and computed tomography revealed acute cholecystitis. Her symptoms did not improve with conservative treatment, so she underwent percutaneous transhepatic gallbladder drainage. Subsequently, peripheral neuropathy, erythematous papules on the skin, and dyspnea developed. A chest computed tomography scan showed bilateral pulmonary infiltrates. A pathological examination of the skin lesion indicated necrotizing vasculitis with eosinophilic infiltrates. She was diagnosed with Churg-Strauss syndrome. She was treated with corticosteroids, and her condition improved dramatically. After the drainage catheter was removed, complications including a bile leak occurred. Consequently, a cholecystectomy was performed.

키워드

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