하지근육에 국한된 증세로 발생한 결절다발동맥염의 2예
Two cases of localized muscle involement by polyarteritis nodosa
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초록
결절다발동맥염에서의 전신적 증세없이 국소적인 골격근 침범은 흔하지 않은 경우로 주로 해당 근육의 근육통, 압통, 부종의 임상증세를 나타낸다. 대부분의 경우 근효소치의 상승은 드물며, 임상경과도 비교적 양성경과를 거치고 예후도 좋다. 침범부위의 조직검사로서 전형적인 괴사혈관염 소견과 근병증을 조기에 진단하는 것이 중요하며, 일단 진단되면 스테로이드 치료가 매우 효과적이다. 근생검시에는 무작위 근생검 보다는 침범된 근육을 근전도나 MRI를 통하여 잘 선택하는 것이 진단양성율을 높일 수 있다. 저자들은 국소적인 골격근 증세로 나타난 결절다발동맥염의 두 증례를 경험하였기에 보고 하는 바이다.
Abstract
Polyarteritis nodosa (PAN) is a multi systemic disease, occasionally described as limited forms of the disease. Localized form of PAN is usually associated with better prognosis. We describe unusual two cases of patients who has suffered from sudden onset of low extremity pain by localized forms of polyarteritis nodosa. Magnetic resonance imaging of the lower legs showed abnormal signal intensity of the suspected muscle. Acute necrotizing arteritis with myopathy has been revealed by muscle biopsy. The symptom of the patient has been improved soon after corticosteroid administration. Muscle biopsy of symptomatic muscles or MRI-directed biopsies can be useful to diagnose this case as PAN with localized myopathies.
참고문헌 (19)
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