소아 그레이브스 병에서 병발한 전신홍반루푸스 1례
A Case of Systemic Lupus Erythematosus with Graves Disease in a Child
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자가면역질환은 동일한 환자에서 각기 다른 자가면역질환들이 동시에 발생하게 되는데, 그 중 자가면역성인 그레이브스병은 전신홍반루푸스, 전신성 경화증, 다발성근염 같은 전신성 류마티스 질환에서 동반이 된다. 특히, 전신홍반루푸스는 자가 면역 질환으로 자가 항체 및 면역 복합체에 의해 신체의 여러 조직 및 세포들이 손상받는 질환이다. 전신홍반루푸스를 앓는 환자들이 그레이브스 병으로 진단받는 것은 성인에서 잘 알려져 있지만 소아와 청소년에서는 그 예가드문 편이다. 이에 저자들은 14세 여자에서 전신홍반루푸스와 함께 그레이브스병이 병발한 1례를 경험하였기에 이에보고하는 바이다.
Abstract
Autoimmune diseases are occasionally associated with other autoimmune diseases in the same patients. Graves disease has been associated with systemic rheumatic diseases including systemic lupus erythematosus (SLE). The diagnosis of Graves disease in patients with SLE is well known, especially in adults, but few case reports have involved children and adolescents. We report a 14-year-old female who presented with Graves disease, proteinuria,arthralgia, decreased complement, and positive antinuclear antibody and who was diagnosed with SLE. Renal biopsy revealed class IV lupus glomerulonephritis. These clinical, laboratory, and histological findings indicate that class IV lupus nephritis may be associated with Graves disease. This possibility should be borne in mind when following patients with Graves disease in order to avoid any delay in the diagnosis and treatment of serious systemic autoimmune diseases such as SLE.
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