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전신 홍반 루푸스에서 발생한 Miller Fisher 증후군 1예

A Case of Miller Fisher Syndrome in a Patient with Systemic Lupus Erythematosus

  • 이용강 (연세대학교 의과대학 내과학교실) ;
  • 박윤혜 (연세대학교 의과대학 내과학교실) ;
  • 최아라 (연세대학교 의과대학 내과학교실) ;
  • 이찬희 (국민건강보험공단 일산병원 류마티스내과) ;
  • 조정희 (국민건강보험공단 일산병원 신경과) ;
  • 김혜영 (국민건강보험공단 일산병원 안과) ;
  • 윤평호 (국민건강보험공단 일산병원 영상의학과)
  • Lee, Yong Kang (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Yoon Hye (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Choi, Ara (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Chan Hee (Division of Rheumatology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital) ;
  • Cho, Jeong Hee (Division of Neurology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital) ;
  • Kim, Hye Young (Division of Ophthalmology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital) ;
  • Yoon, Pyeong Ho (Division of Radiology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital)
  • 발행 : 2012.11.01

초록

전신홍반루푸스에서 신경정신학적 증상은 흔하지만, 드물게 나타나는 뇌신경 장애나 다발성 신경병증에 대한 감별에는 여러 가지 질환들이 포함된다. 저자들은 전신홍반루푸스로 치료받고 있던 남자 환자에서 상기도 감염력이 있은 후 발생한 복시, 안검하수, 운동실조로 내원하여 신경학적 검사 및 항 GQ1b항체 검사를 통해 진단된 Miller Fisher 증후군을 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Neuropsychiatric events are common in patients with systemic lupus erythematosus (SLE). The estimated incidence of neuropsychiatric SLE (NPSLE) is 30 to 40%. However, NPSLE poses a difficult diagnostic challenge because a variety of conditions should be considered in the differential diagnosis, especially when patients present with uncommon or rare NPSLE features. We herein describe a 49-year-old man with SLE who initially presented with diplopia, ptosis, and gait disturbance that had developed 1 week after an upper respiratory tract infection. He was finally diagnosed with Miller Fisher syndrome (a variant of Guillain-$Barr{\acute{e}}$ syndrome) according to clinical symptoms, anti-GQ1b antibody positivity, and neurological study results. The patient recovered without sequelae with intravenous immunoglobulin therapy. This is the first report to describe a case of Miller Fisher syndrome that developed in a patient with SLE in Korea and suggests that Miller Fisher syndrome should be included as a differential diagnosis of NPSLE.

키워드

참고문헌

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