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증례 : 감염 ; 가역적 청력 손실을 동반한 쯔쯔가무시병 1예
김동민 ( Dong Min Kim ),허성재 ( Seong Jae Huh ),임경훈 ( Kyung Hun Lim ),도기원 ( Gi Won Do ),홍순형 ( Soon Hyoung Hong ),원영철 ( Young Cheol Weon ),전재범 ( Jae Bum Jun ) 대한내과학회 2009 대한내과학회지 Vol.77 No.6
저자들은 68세 여자에서 가역적 청력손실을 동반한 쯔쯔가무시병을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 의식혼탁을 주소로 내원하여 시행한 쯔쯔가무시혈청 항체 검사상 양성으로 독시사이클린 200 mg로 치료하였고, 청력손실을 호소하여 시행한 뇌 자기공명영상에서 청력손실의 병변이 확인되었다. 환자의 청력은 추가적인 치료없이 점차적으로 완전히 회복되었다. Scrub typhus, which is caused by Orientia tsutsugamushi, is an acute febrile illness characterized by fever, rash, and myalgia. Recently, its incidence in Korea has increased. Many cases of scrub typhus with central nervous system involvement have been reported, while cases with hearing loss are rare. We experienced a case of scrub typhus with reversible hearing loss. To our knowledge, this is the first case confirmed by magnetic resonance imaging. (Korean J Med 77:793-796, 2009)
김종형 ( Jong Hyung Kim ),오지선 ( Ji Seon Oh ),김동민 ( Dong Min Kim ),허성재 ( Seong Jae Huh ),임경훈 ( Kyung Hun Lim ),도기원 ( Gi Won Do ),홍순형 ( Soon Hyung Hong ),최승원 ( Seung Won Choi ) 대한류마티스학회 2010 대한류마티스학회지 Vol.17 No.1
Periorbital edema is a rare manifestation of systemic lupus erythematosus (SLE). We describe here a patient with bilateral periorbital edema as a presenting symptom of SLE. A 23-year-old woman was admitted for a sudden onset of severe periorbital edema that developed 7 days previously. On the basis of the malar rash, arthritis of the right hand and left wrist, leukopenia, proteinuria and the positive anti-nuclear and anti-dsDNA antibodies, she was diagnosed with SLE. Kidney biopsy revealed lupus nephritis (WHO class IV). After treatment with high dose of steroids, intravenous cyclophosphamide and daily hydroxychloroquine, her symptoms resolved, including the periorbital edema. She was discharged with prescriptions for prednisolone and hydroxychloroquine and she remains well.