The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Ankylosing Spondylitis Accompanied by Henoch-Sch$\ddot{o}$nlein Purpura and Chronic Inflammatory Demyelinating Polyneuropathy

만성 염증성 탈수초성 다발신경병증과 헤노흐-쇤라인 자반증을 동반한 강직성 척추염 1예

  • Choi, Byoong-Yong (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kwon, Hyun-Mi (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Sung, Jung-Jun (Department of Neurology, Seoul National University College of Medicine) ;
  • Park, Seong-He (Department of Pathology, Seoul National University College of Medicine) ;
  • Song, Yeong-Wook (Department of Internal Medicine, Seoul National University College of Medicine)
  • 최병용 (서울대학교 의과대학 내과학교실) ;
  • 권현미 (서울대학교 의과대학 내과학교실) ;
  • 성정준 (서울대학교 의과대학 신경과학교실) ;
  • 박성혜 (서울대학교 의과대학 병리학교실) ;
  • 송영욱 (서울대학교 의과대학 내과학교실)
  • Published : 2012.10.01
⟨ Previous Next ⟩

Abstract

Peripheral nervous system dysfunction is a rare complication in Henoch-Sch$\ddot{o}$nlein purpura, but it tends to recover spontaneously without treatment. A 78-year-old man who had ankylosing spondylitis presented with Henoch-Sch$\ddot{o}$nlein purpura associated with progressive sensorimotor polyneuropathy. He was diagnosed with chronic inflammatory demyelinating polyneuropathy, which did not improve despite intravenous immunoglobulin therapy. We describe a case of Henoch-Sch$\ddot{o}$nlein purpura, accompanied by chronic inflammatory demyelinating polyneuropathy in a patient with ankylosing spondylitis.

저자들은 피부 자반과 점진적인 하지 근력 약화를 주소로 내원한 강직성 척추염 환자에서 헤노흐-쇤라인 자반증을 진단하고, 임상 증상, 전기생리학적 검사 및 신경 조직 검사를 통해 만성 염증성 탈수초성 다발 신경병증이 동반된 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Garzoni L, Vanoni F, Rizzi M, et al. Nervous system dysfunction in Henoch-Schonlein syndrome: systematic review of the literature. Rheumatology (Oxford) 2009;48: 1524-1529. https://doi.org/10.1093/rheumatology/kep282
  2. Saperstein DS, Katz JS, Amato AA, Barohn RJ. Clinical spectrum of chronic acquired demyelinating polyneuropathies. Muscle Nerve 2001;24:311-324. https://doi.org/10.1002/1097-4598(200103)24:3<311::AID-MUS1001>3.0.CO;2-A
  3. Mills JA, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis Rheum 1990;33: 1114-1121.
  4. Beauvais C, Kaplan G, Mougenot B, Michel C, Marinho E. Cutaneous vasculitis and IgA glomerulonephritis in ankylosing spondylitis. Ann Rheum Dis 1993;52:61-62. https://doi.org/10.1136/ard.52.1.61
  5. Kim SJ, Lim TK, Kim YJ, et al. A case of ankylosing spondylitis in a patient with Henoch-Schonlein purpura. J Korean Rheum Assoc 2008;15:268-272. https://doi.org/10.4078/jkra.2008.15.3.268
  6. Barohn RJ, Kissel JT, Warmolts JR, Mendell JR. Chronic inflammatory demyelinating polyradiculoneuropathy: clinical characteristics, course, and recommendations for diagnostic criteria. Arch Neurol 1989;46:878-884. https://doi.org/10.1001/archneur.1989.00520440064022
  7. Laughlin RS, Dyck PJ, Melton LJ 3rd, Leibson C, Ransom J, Dyck PJ. Incidence and prevalence of CIDP and the association of diabetes mellitus. Neurology 2009;73:39-45. https://doi.org/10.1212/WNL.0b013e3181aaea47
  8. Kalita J, Misra UK, Yadav RK. A comparative study of chronic inflammatory demyelinating polyradiculoneuropathy with and without diabetes mellitus. Eur J Neurol 2007; 14:638-643. https://doi.org/10.1111/j.1468-1331.2007.01798.x
  9. Bouchra A, Benbouazza K, Hajjaj-Hassouni N. Guillain- Barre in a patient with ankylosing spondylitis secondary to ulcerative colitis on infliximab therapy. Clin Rheumatol 2009;28(Suppl 1):S53-S55.
  10. Benedetti L, Briani C, Franciotta D, et al. Rituximab in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a report of 13 cases and review of the literature. J Neurol Neurosurg Psychiatry 2011;82:306-308. https://doi.org/10.1136/jnnp.2009.188912