강직성척추염의 악화로 오인된 장요근 농양
Iliopsoas Abscess Misconstrued as Aggravated Ankylosing Spondylitis
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초록
저자들은 항종양괴사인자 저해제 치료를 받은 강직척추염 환자에서 발생한 장요근 농양을 국내 최초로 보고하는바이며 강직척추염 환자에서 새롭게 발생한 한쪽 고관절 및엉치 통증 발생 시 질환의 악화뿐 아니라 장요근 농양 및 기타 증상을 유발할 수 있는 질환에 대해 반드시 감별 진단을고려해야 함을 문헌고찰과 함께 보고하는 바이다.
Abstract
An iliopsoas abscess is a collection of pus in the iliopsoas muscle caused by the direct spread of infection from adjacent internal organs or by hematogenous or lymphatic spread from distal sites. Its symptoms are vague back, hip, thigh or lower abdomen pain with insidious onset, similar to those of ankylosing spondylitis (AS). Therefore diagnosing an iliopsoas abscess in patients with AS is difficult. A forty-three year-old man was treated with adalimumab, a tumor necrosis factor inhibitor, and clinical symptoms were subsequently observed to improve. One year after voluntary discontinuation of adalimumab, the patient returned with a recurrence of right buttock pain and was diagnosed as having aggravated AS. Following re-initiation of adalimumab, symptoms did not improve and fever developed. On the basis of imaging studies, the patient was diagnosed as having an iliopsoas abscess and was successfully treated with intravenous antibiotics.
참고문헌 (9)
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