The Korean Journal of Medicine
- 제89권1호
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- Pages.122-126
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- 2015
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- 1738-9364(pISSN)
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- 2289-0769(eISSN)
DOI QR Code
류마티스관절염 환자에서 동반된 혈전혈소판감소자색반병 1예
A Case of Rheumatoid Arthritis Accompanied by Thrombotic Thrombocytopenic Purpura
- 강성민 (메리놀병원 류마티스내과) ;
- 이지현 (메리놀병원 류마티스내과) ;
- 구인혜 (메리놀병원 류마티스내과) ;
- 김해구 (메리놀병원 류마티스내과) ;
- 남경식 (메리놀병원 류마티스내과) ;
- 박석기 (메리놀병원 류마티스내과)
- Kang, Sung Min (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
- Lee, Ji Hyun (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
- Ku, In Hye (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
- Kim, Hae Koo (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
- Nam, Kyoung Sik (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
- Park, Suk Ki (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center)
- 발행 : 20150000
초록
혈전혈소판감소자색반병은 혈소판 감소, 미세혈관병증용 혈빈혈과 신경학적 기능 이상이 특징인 질환으로 드물게 자가면역질환과 관련되어 발생한다. 저자들은 류마티스관절염 환자에서 수술 후 요로 감염과 함께 의식 저하 및 미세혈관 병증용혈빈혈, 혈소판 감소가 발생하여 혈전혈소판감소자색 반병으로 진단 후 혈장분리교환술과 고용량의 스테로이드로 치료하여 의식 저하 및 빈혈, 혈소판 감소는 호전을 보였으나 결국 폐혈증으로 사망한 1예를 경험하고 문헌고찰과 함께 보고하는 바이다.
Thrombotic thrombocytopenic purpura (TTP) is a blood coagulation disorder that damages numerous organs, including the kidney, heart and brain. Features indicative of TTP include thrombocytopenia, microangiopathic hemolytic anemia, neurologic symptoms, kidney failure and fever. Infections, toxins, pregnancy and, rarely, autoimmune diseases are all known to be associated with TTP. We encountered a rare case of rheumatoid arthritis accompanied by TTP following tympanoplasty. The patient’s confusion, thrombocytopenia and renal failure all improved after plasmapheresis and high-dose glucocorticoid therapy, but she eventually expired due to sepsis. We report on this case herein and also review the relevant literature.
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