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장막간 혈관염에 의한 소장 경색을 동반한 전신성 홍반성 루푸스
노대근 ( Dae Keun Lo ),박윤희 ( Yoon Hee Park ),양형인 ( Hyung In Yang ),박성환 ( Sung Hwan Park ),이상헌 ( Sang Heon Lee ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ),김병기 ( Byung Kee Kim ),고응복 ( Yong Bok Koh ) 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.1
Systemic lupus erythematosus (SLE) is an autoimmune disease involving many organs. Mesenteric vasculitis is one of the serious organ involvement in this disease. Mesenteric vasculitis may produce mucosal ulceration. bowel edema with paralytic ileus, hemorrhagic ileitis, intussusception, perforation and mesenteric infarction. Because of high mortality rate, early diagnosis and treatment of this manifestation is very important. We experienced a case of SLE with extensive smell bowel infarction due to mesenteric vasculitis. She was 29 years old. She was suffered frem severe abdominal pain for three days. Abdominal computed tomography showed diffusse wall thickening of the small intestinal wall. After high dose intravenous steroid, her abdominal symptoms were improved. She was discharged with low dose oral steroid(15mg/day) treatment. Seven months later, she presented with sudden abdominal pain. Intravenous methyl-prednisolon (2mg/Kg) was started. Three days later. her abdominal symptoms were not subsided. On the plain radiograph of the abdomen, marked ileus was demonstrated. Mesenteric angiography showed diffuse decreased small bowel vascularity. A provisional diagnosis of small bowel infarction and obstruction, we performed exploratory laparotomy. She undergone small bowel segmental resection. The diagnosis was small bowel infaction due to mesenteric vasculitis.
민도준,노대근,민준기,홍연식,이상헌,박성환,조철수,김호연 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.3
Objectives: Anti-Ro antibody is one of the prominent anti-nuclear antibodies in patients with systemic lupus erythematosus(SLE). This study was designed to determine whether this antibody reacts with certain antigenic determinants and to evaluate the frequency and clinical associations of anti-Ro antibody in patients with SLE. Method: Double immunodiffusion(DID) were used to detect anti-Ro antibody with sera from 151 patients with SLE. Western .blot analysis was done in 57 patients who were positive for anti-Ro antibody in DID to find out the major antigenic determinant of Ro antigen. We evaluated the presence of anti-Ro antibody and associations with clinical features in SLE. Result: 1) Anti-Ro by DID were positive in 56% (84 of 151 cases) of patients with SLE. 2) Photosensitivity(59% versus 27%, P=0.0001), cutaneous lesion of all types (80% versus 58%, P=0.004), malar rash (67% versus 49%, P=0.025), leukopenia (38% versus 22%, P=0.036) were closely associated with anti-Ro positivity. But there was no significant difference between anti-Ro positive and negative patients in other clinical findings such as sicca complex, thrombocytopenia and nephritis 3) In Western blot analysis, 38 of 57 Ro positive sera had antibodies to the 60-kD and the 52-kD peptide, 8 cases of them revealed antibody to the 60-kD peptide without concomitant antibody to the 52-kD, and only one had isolated presence of antibody to 52-kD peptide. Ten of immunodiffusion defined anti-Ro sera were not reactive with the Ro proteins by Western blot analysis. Conclusions: In patients with SLE, the presence of anti-Ro antibody is closely associated with photosensitive cutaneous lesion and leukopenia, and the major antigenic determinant of anti-Ro sera in SLE is 60-kD peptide.