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Henoch-Sch$\ddot{O}$nlein Purpura in a Patient with Ankylosing Spondylitis after Infliximab Therapy

강직성 척추염 환자에서 Infliximab 투여 후 헤노흐-쇤라인 자색반 1예

  • Jung, Woo-Jin (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Nam, Yoon-Jeong (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Seung-Geun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Ji-Min (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Song, Margaret (Department of Dermatology, Pusan National University School of Medicine) ;
  • Kim, Moon-Bum (Department of Dermatology, Pusan National University School of Medicine) ;
  • Kim, Geun-Tae (Department of Internal Medicine, Kosin University College of Medicine)
  • 정우진 (부산대학교 의학전문대학원 내과학교실) ;
  • 남윤정 (부산대학교 의학전문대학원 내과학교실) ;
  • 이승근 (부산대학교 의학전문대학원 내과학교실) ;
  • 김지민 (부산대학교 의학전문대학원 내과학교실) ;
  • 송마가렛 (부산대학교 의학전문대학원 피부과학교실) ;
  • 김문범 (부산대학교 의학전문대학원 피부과학교실) ;
  • 김근태 (고신대학교 의과대학 내과학교실)
  • Received : 2012.08.16
  • Accepted : 2012.11.07
  • Published : 2013.05.01

Abstract

Tumor necrosis factor alpha (TNF-${\alpha}$) inhibitors are used widely to treat patients with active rheumatoid arthritis and ankylosing spondylitis (AS). Although various cutaneous reactions can occur as side effects of TNF-${\alpha}$ inhibitors, systemic vasculitis requiring withdrawal of the agent and immunosuppressive drugs is rare. A 59-year-old male with AS who had been treated with infliximab for 60 months visited us with complaints of palpable purpura on both legs and severe abdominal pain. Abdominal computed tomography showed diffuse wall thickening of the proximal jejunum and ileum and a skin biopsy revealed leukocytoclastic vasculitis. The patient was diagnosed with Henoch-Sch$\ddot{O}$nlein purpura (HSP). Infliximab was discontinued and systemic steroid therapy at 0.5 mg/kg resulted in prompt resolution of the HSP. Here, we report the first case of HSP in a patient with AS after infliximab treatment.

저자들은 강직성 척추염 환자에서 infliximab을 사용한 이후 발생한 헤노흐-쇤라인 자색반을 진단하고 약제 중단 및 스테로이드 요법으로 재발 없이 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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