소아에서 성장호르몬 치료 중 발생한 특발유두부종과 결합된 가성유두부종
Pseudopapilledema Combined with Idiopathic Papilledema in a Child Receiving Growth Hormone Treatment
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목적: 성장호르몬 치료 중 특발유두부종과 결합된 가성유두부종이 발생한 소아 환자 1예를 보고하고자 한다. 증례요약: 특별한 기저질환이 없는 11세 여아가 3개월간 성장호르몬 치료를 받고 발생한 일시적 시야흐림, 암순응 장애 및 무기력감을 주소로 타원에 내원하였다. 이학적 검사상 20/20에서 20/25로의 시력저하와 안저검사에서 양안에 유두부종이 발견되었고, 즉시 성장호르몬 치료를 중단하였다. 4주 후, 본원에 방문하였을 때 안저검사상 유두부종은 양안에 비슷한 정도로 관찰되었고 우안의 경미한 적록 색각이상만 보였다. 성장호르몬 투여로 인한 특발유두부종과 결합된 가성유두부종을 의심하였고, 성장호르몬 투여 중단을 지속하며 유두부종에 대하여 경과 관찰하기로 하였다. 결론: 성장호르몬 치료 중 안저검사상 양안 유두부종이 관찰되어, 성장호르몬 치료를 중단하였고, 4주 후 시력장애는 호전되었지만 경도의 유두부종과 결합된 가성유두부종이 그대로 남아있는 환자를 보고하는 바이다.
Abstract
Purpose: We report a case of pseudopapilledema combined with idiopathic papilledema in a pediatric patient receiving growth hormone treatment. Case summary: An 11-year-old girl without any underlying disease presented with bilateral transient visual obscurations, a dark-adaptation disorder, and helplessness that developed while she had been on growth hormone therapy for 3 months at a local clinic. Reduced visual acuity (from 20/20 to 20/25) was observed on physical examination and bilateral optic disc edema on fundus examination, growth hormone was immediately discontinued. Four weeks later, fundus examination revealed papilledema of both eyes with mild red-green dyschromatopsia. Recombinant growth hormone-associated idiopathic papilledema combined with pseudopapilledema was suspected. Although growth hormone, had been discontinued, we scheduled further observation of the papilledema. Conclusions: Papilledema was observed on fundus examination during growth hormone treatment and four weeks after discontinuation thereof. The symptoms improved, but mild papilledema combined with pseudopapilledema remained.
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