동종 조혈모세포이식 후 다발성 근염으로 발현된 만성 이식편대숙주반응
Polymyositis as a manifestation of chronic graft-versus-host disease after allogeneic bone marrow transplantation
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초록
동종 조혈모세포이식 후의 합병증으로 드물게 다발성근염으로 만성 이식편대숙주반응이 생길 수 있으며, 경우에 따라 치명적일 수 있으므로 조기 진단이 중요하겠다. 그러나, 임상 양상이 비특이적일 경우 진단이 쉽지 않으며 이식 후 수 년 뒤에도 유일한 이식편대숙주반응으로 발현될 수 있어 동종 조혈모세포이식을 받았던 환자를 진료할 때에는 이에 대한 주의가 필요하겠다.
Abstract
Chronic graft-versus-host disease (cGVHD) remains one of the major complications of allogeneic hematopoietic stem cell transplantation. Although cGVHD has various manifestations in almost all organs, cases of cGVHD involving skeletal muscle are rare. We experienced a 26-year-old man with polymyositis with no other concurrent cGVHD after HLA-matched myeloablative transplantation for acute myelogenous leukemia. He had a history of acute and chronic GVHD. The patient complained of fever and myalgia 3 years after transplantation. The serum creatine kinase (CK, 2,223 IU/L) and aldolase (87.6 sigmaU/mL) were elevated. The muscle biopsy and electromyographic findings were consistent with myositis with necrosis. His condition improved dramatically with immunosuppressive therapy. Although muscle involvement, alone, in cGVHD is very rare, early diagnosis and proper treatment are still important.
참고문헌 (9)
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