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증례 : 류마티스 ; 류마티스 관절염에서 발생한 급성 횡단척수염 치료 1예
김보라 ( Bo Ra Kim ),권혁이 ( Hyucki Kwon ),김지현 ( Ji Hyun Kim ),박성현 ( Sung Hyun Park ),정재훈 ( Jae Hoon Jeong ),정진선 ( Jin Seon Jeong ),문기원 ( Ki Won Moon ) 대한내과학회 2015 대한내과학회지 Vol.89 No.5
본 증례는 류마티스 관절염 환자에서 발생한 급성 횡단 척추염을 면역글로불린 정주로 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다. Acute transverse myelitis (ATM) is a heterogeneous syndrome characterized by acute spinal cord dysfunction resulting in paresis and sensory and autonomic impairment below the level of the lesion. The etiology of ATM includes parainfectious, paraneoplastic, drug-induced, systemic autoimmune disorders, and acquired demyelinating diseases. ATM is very rare in patients with rheumatoid arthritis (RA). A 79-year-old woman with RA, a recurring peptic ulcer, and congestive heart failure presented with acute weakness of both upper and lower extremities. She was diagnosed with ATM based on the results of laboratory and radiological tests. ATM is usually treated with high-dose glucocorticoid. However, we treated her with intravenous immunoglobulin (IVIG) considering the adverse events of high-dose glucocorticoid, and she improved. We report a case of ATM in a patient with RA successfully treated with IVIG. (Korean J Med 2015,89:604-608)