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임미경 ( Mi Kyoung Lim ),이성순 ( Sung Soon Lee ),박효숙 ( Hyo Suk Park ),김찬 ( Chan Kim ),장윤혜 ( Yun Hae Chang ),최승원 ( Seung Woon Choi ),유빈 ( Bin Yoo ),문희범 ( Hae Bom Moon ) 대한류마티스학회 1995 대한류마티스학회지 Vol.2 No.2
Intravesical instillation of BCG (Calmette-Guerin Bacillus) is the most widely used treatment of superficial transitional cell carcinoma of the bladder. While the exact mechanisms are not yet known, it is assumed that the recognition of tumor antigen is enhanced by immunologic response of the urothelium of mycobacterium. Various complications have been reported after BCG treatment and arthritis is observed in 0.5 to% of treated patients. This from of arthritis may be attributed to an antigen of mycobacterium sharing a cross reactive epitope with an antigen in articular cartilage. A 40-year-old male had transurethral resection and intravesical instillation of BCG for transitional cell carcinoma of bladder. Within few days of the fourth instillation, he developed arthritis on right knee and right metatarsal joint. Laboratory findings showed nonspecific inflammatory sign, positive HLA B27, negative rheumatoid facor and negative antinuclear antibody. The joint effusion was aseptic. He was treated with nonsteroidal antiinflammatory drugs (indomethacin 200mg/day) with resolution of arthritis symptom. We report a patient who developed an inflammatory oligoarthritis following intravesical instillation of BCG for the treatment oof bladder cancer.
정재락 ( Jae Rak Chung ),윤제헌 ( Je Hyun Yoon ),이상곤 ( Sang Gon Lee ),엄대운 ( Dae Woon Eom ),우영주 ( Young Joo Woo ),최승원 ( Seung Won Choi ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.3
Primary Sjogren`s syndrome is a chronic autoimmune disorder characterized by xerostomia and keratoconjunctivitis sicca result from lymphocytic infiltrations of salivary and lacrimal glands. It may accompany by the wide spectrums of extraglandular symptoms, such as musculoskeletal, pulmonary, renal, intestinal, hematologic, and nervous system. However, overt cardiac manifestations are very rare and are documented only a few cases sporadically. We report a patient with primary Sjogren`s syndrome who developed reversible congestive heart failure as part of a myocarditis. A 39-year-old woman with primary Sjogren`s syndrome developed fatigue, dyspnea, and abdominal discomfort. An echocardiography revealed global hypokinetic left ventricle with markedly decreased ejection fraction (EF=39%), abnormal restrictive filling pattern, secondary tricuspid valve insufficiency and no pericardial effusion or thickening. A myocardial biopsy disclosed myocardial degeneration with lymphocyte infiltration. Following treatment with digitalis, diuretics, ACE inhibitor and corticosteroid, the symptoms of congestive heart failure improved. A repeat echocardiography showed an improved ventricular contractility and recovered both diastolic (normalized E/A ratio) and systolic (EF=50%) functions.