DOI QR코드

DOI QR Code

단백질 C와 S 결핍증 환자에서 발생한 자발성 신동맥 박리 1예

Spontaneous Renal Artery Dissection in a Patient with Protein C and S Deficiency

  • 임예지 (가톨릭대학교 의과대학 내과학교실) ;
  • 이래석 (가톨릭대학교 의과대학 내과학교실) ;
  • 유현아 (가톨릭대학교 의과대학 내과학교실) ;
  • 장경윤 (가톨릭대학교 의과대학 내과학교실) ;
  • 서재현 (가톨릭대학교 의과대학 내과학교실) ;
  • 이관현 (청주성모병원 내과) ;
  • 황대연 (청주성모병원 내과)
  • Lim, Ye Jee (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Rae Seok (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Yu, Hyun Ah (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Chang, Kyung Yoon (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Seo, Jae Hyun (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Kwan Hyun (Department of Internal Medicine, Cheongju St. Mary Hospital) ;
  • Hwang, Dae Yeon (Department of Internal Medicine, Cheongju St. Mary Hospital)
  • 발행 : 2013.01.01

초록

일반적으로 임상에서 신동맥 박리는 대동맥 박리와 연관되어 발생하지만, 외상이나 기저질환이 없이 저절로 발생하는 자발성 신동맥 박리의 경우 알려진 다른 원인이 없거나 반복적인 동정맥 혈전증의 병력이 있을 경우 단백질 C, 단백질 S 등 혈액학적 이상을 확인할 필요가 있겠다. 이에 저자들은 자발성 신동맥 박리와 단백질 C와 S 결핍증이 동반되어 있는 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Spontaneous renal artery dissection without aortic dissection in normotensive patients is rarely reported. Spontaneous renal artery dissection is also an uncommon cause of renal infarction that occurs, though rarely, in patients with hypercoagulable states such as protein C and S deficiency. We report here a case of spontaneous renal artery dissection and renal infarction associated with protein C and S deficiency.

키워드

참고문헌

  1. Oh SJ, Kim HY, Kwon SG, et al. A case of spontaneous renal artery dissection causing renal infarction in a previously healthy man. Korean J Nephrol 2002;21:831-836.
  2. Edwards BS, Stanson AW, Holley KE, Sheps SG. Isolated renal artery dissection, presentation, evaluation, management, and pathology. Mayo Clin Proc 1982;57:564-571.
  3. Aiach M, Borgel D, Gaussem P, Emmerich J, Alhenc-elas M, Gandrille S. Protein C and protein S deficiencies. Semin Hematol 1997;34:205-216.
  4. Hayashida M, Yamada H, Yamazaki S, et al. Combined protein C and protein S deficiency in a family with repetitive thromboembolism and segregated gene mutations. Intern Med 2003;42:268-272. https://doi.org/10.2169/internalmedicine.42.268
  5. D'Angelo A, Vigano-'Angelo S, Esmon CT, Comp PC. Acquired deficiencies of protein S. Protein S activity during oral anticoagulation, in liver disease, and in disseminated intravascular coagulation. J Clin Invest 1988;81:1445-1454. https://doi.org/10.1172/JCI113475
  6. Horai Y, Miyamura T, Hirata A, et al. Idiopathic portal hypertension in a patient with mixed connective tissue disease and protein C deficiency. Intern Med 2010;49:2013-2016. https://doi.org/10.2169/internalmedicine.49.3834
  7. Gleeson EM, O'Donnell JS, Preston RJ. The endothelial cell protein C receptor: cell surface conductor of cytoprotective coagulation factor signaling. Cell Mol Life Sci 2012;69:717-726. https://doi.org/10.1007/s00018-011-0825-0
  8. John SG, Pillai U, Vaidyan PB, Ishiyama T. Spontaneous renal artery dissection. Mo Med 2010;107:124-126.
  9. Misrai V, Peyromaure M, Poiree S, Marteau V, Laurian C. Spontaneous dissection of branch renal artery-is conservative management safe and effective? J Urol 2006;176:2125-2129. https://doi.org/10.1016/j.juro.2006.07.017
  10. Lee SH, Lee HC, Oh SJ, et al. Percutaneous intervention of spontaneous renal artery dissection complicated with renal infarction: a case report and literature review. Catheter Cardiovasc Interv 2003;60:335-338. https://doi.org/10.1002/ccd.10657