난치성 딸꾹질을 주 증상으로 나타낸 능형 뇌염 1례
A Case of Rhombencephalitis Presented with Intractable Hiccup
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초록
난치성 딸꾹질은 딸꾹질이 24시간 1) 혹은 48 이상 2) 지속되는 경우를 말하며 소화기계 질환, 호흡기계 질환, 약물, 대사적 질환, 정신 심리적 질환, 중추신경계 질환 등에동반 될수있다. 저자들은 1주일이상 지속되는 난치성 딸꾹질로 입원한 14세 9개월여자 환자에서 뇌척수액 검사 및 뇌 MRI 소견으로능형 뇌염으로 진단하였고, 이 환자에서 고농도 스테로이드 요법 및 IVIG 사용 후 임상적 회복을 보인능형뇌염 1례를 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다.
Abstract
The term 'rhombencephalitis' refers to inflammatory diseases affecting the hindbrain. We experienced a case of rhombencephalitis in a 14 years old girl, who presented with fever, headache, and intractable hiccup for one week prior to admission. Brain MRI on admission showed bilateral high signal intensities in the dorsal portion of the medulla oblongata on T2WI and FLAIR. Examination of cerebrospinal fluid showed increased WBC count (33/mm3, Lymphocyte 81%), normal protein and glucose level. Immunoserologic study showed decreased C3, C4 level and increased Anti-ds DNA level. However, FANA was negative. The hiccup was controlled by administration of IVIG (1 g/kg/day for 2 days) and steroid (30 mg/kg/day for 3days) without any neurologic symptoms. We report a case with the brief review of related literatures.
참고문헌 (15)
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