전신홍반성 루프스와 동반된 맥락망막병증 및 이차성 급성 폐쇄각 발작 1예
Choroidoretinopathy and Secondary Angle Closure Attack in Systemic Lupus Erythematosus: A Case Report
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 전신홍반성 루프스(루프스)는 만성 자가면역 질환으로 전신에 침범할 수 있으나 안구, 특히 맥락막을 침범하는 경우는 드문 것으로 알려져 있다. 본 증례에서는 루프스에 의한 양안 맥락망막병증 및 이로 인한 이차적인 급성 폐쇄각 발작이 발생한 1예를 보고하고자 한다. 증례요약: 우측 음낭 부종(scrotal swelling)으로 비뇨기과 입원 중인 58세 남자가 양안 충혈 및 통증으로 안과 협진의뢰되었다. 안저소견상 맥락망막염, 맥락막박리가 관찰되었으며, 이차적인 양안 급성 폐쇄각 발작이 세극등검사 및 안압검사를 통하여 확인되었다. 류마티스내과를 통하여 혈액검사를 포함한 전신 감별 검사를 시행하였으며, 전신홍반성 루프스가 진단되었다. 전신성 스테로이드 및안압하강제치료 시행 후, 양안 맥락망막염 호전과 함께 안압 하강 및 맥락막박리가 소실되었다. 결론: 루프스에서 양안 맥락망막병증과 동반되어 이차적인 급성 폐쇄각 발작이 나타날 수 있으며, 전신적 스테로이드 및 안압하강제사용이 치료에 도움이 된다.
Abstract
Purpose: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with widespread manifestations that rarely include the eye. We present a case of SLE-associated choroidoretinopathy and secondary angle closure attack in both eyes. Case summary: A 58-year-old male was admitted into the urologic department complaining of right scrotal swelling, and then consulted with the ophthalmology department regarding both ocular pain and eye injection. The patient was diagnosed with acute angle closure attack using a slit lamp test and tonometry secondary to choroidoretinitis with choroidal detachment at fundus examination in both eyes. The rheumatologist performed systemic evaluation, including serologic tests, and then diagnosed the patient with SLE. After systemic steroid therapy, intraocular pressure was decreased and choroidal detachment disappeared with improvements of choroidoretinitis in both eyes. Conclusions: Patients with systemic lupus erythematosus choroidopathy can develop secondary angle closure attack, which can be effectively treated using systemic steroid therapy and antiglaucoma drugs.
참고문헌 (17)
- Sivaraj RR., "Ocular manifestations of systemic lupus erythematosus", Rheumatology(Oxford), 46, pp.1757~1762 (2007)
- Hochberg MC, "Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus", Arthritis Rheum, 40, pp.1725~ (1997)
- 윤창기, "전신홍반루프스 환자에서 발생한 망막병증", 대한안과학회지, 50(8), pp.1215~1220 (2009), 대한안과학회
- Edouard S., "Bilateral choroidopathy in systemic lupus erythematosus", Lupus, 20, pp.1209~1210 (2011)
- Han YS., "Secondary angle closure glaucoma by lupus choroidopathy as an initial presentation of systemic lupus erythematosus : a case report", BMC ophthalmol, 15, pp.148~ (2015)
- Lavina AM., "Lupus choroidopathy and choroidal effusions", Retina, 22, pp.643~647 (2002)
- Wisotsky BJ., "Angle-closure glaucoma as an initial presentation of systemic lupus erythematosus", Ophthalmology, 105, pp.1170~1172 (1998)
- Gäckle HC., "Central serous chorioretinopathy. Clinical, fluorescein angiography and demographic aspects", Ophthalmologe, 95, pp.529~533 (1998)
- Chaine G., "Central serous chorioretinopathy and systemic steroid therapy", J Fr Ophtalmol, 24, pp.139~146 (2001)
- Baglio V., "Choroidopathy in patients with systemic lupus erythematosus with or without nephropathy", J Nephrol, 24, pp.522~529 (2011)
- A. A. Bengtsson, "Systemic lupus erythematosus: still a challenge for physicians", Journal of Internal Medicine, 281(1), pp.52~64 (2017), Wiley-Blackwell[DOI]
- Kamdar NV., "Choroidopathy and kidney disease : a case report and review of the literature", Cases J, 2, pp.7425~ (2009)
- Kuehn MW., "Primary testicular manifestation of systemic lupus erythematosus", Eur Urol, 16, pp.72~73 (1989)
- Elagouz M., "Uveal effusion syndrome", Surv Ophthalmol, 55, pp.134~145 (2010)
- Ikeda N., "Ciliochoroidal effusion syndrome associated with posterior scleritis", Jpn J Ophthalmol, 51, pp.49~52 (2007)
- Palejwala NV., "Ocular manifestations of systemic lupus erythematosus : a review of the literature", Autoimmune Dis, 2012, pp.290898~ (2012)
- Shimura M., "Choroiditis in systemic lupus erythematosus : systemic steroid therapy and focal laser treatment", Jpn J Ophthalmol, 47, pp.312~315 (2003)