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쯔쯔가무시병 후에 발생한 ANCA 연관 혈관염에 의한 말초성 신경 염 1예

 강윤  ;  장희원  ;  한상훈  ;  정수진  ;  구남수  ;  백지현  ;  김창오  ;  최준용  ;  송영구  ;  이사라  ;  박용범  ;  이수곤  ;  김승민  ;  김준명 
 INFECTION AND CHEMOTHERAPY, Vol.43(1) : 82-85, 2011 
Journal Title
Issue Date
ANCA-associated vasculitis ; Scrub typhus ; Tsutsugamushi disease
Anti-neutrophilic cytoplasmic antibody (ANCA)-associated vasculitis is a primary
systemic vasculitis that affects the small vessels, and ANCA is involved as the
common pathogenesis. Environmental factors such as infectious agents have been
considered to play a role in triggering the autoimmunity. We report here on a case
of ANCA-associated vasculitis that developed after scrub typhus. A 64-year-old
male was admitted because of fever, chills, pain, weakness and hypoesthesia of
his calves. He was diagnosed as having scrub typhus based on the findings of an
eschar and the positive serum anti-orientia antibody. The fever continued despite
the antibiotic treatment. Neurologic symptoms such as numbness, hypoesthesia
and weakness began to develop in the hands, feet and calves with a persisting
fever. The nerve conduction velocity study revealed mononeuritis multiplex of the
superficial peroneal nerve and the median nerve. Microscopic hematuria then
additionally developed, and the serology showed a positive myeloperoxidase
(MPO) test. A nerve biopsy was conducted on the left superficial peroneal
nerve and the result showed non-infectious systemic vasculitis of the mediumsmall
arteries. He was diagnosed as having microscopic polyangiitis along with
ANCA associated vasculitis. The fever resolved and the neurologic symptoms
began to improve after steroid pulse treatment (methylprednisolone 1 g/day). The
neuropathy gradually improved after discharge. We presume that the ANCAassociated
vasculitis was triggered by scrub typhus.
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6. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Yoon(강윤)
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Seung Min(김승민) ORCID logo https://orcid.org/0000-0002-4384-9640
Kim, June Myung(김준명)
Kim, Chang Oh(김창오) ORCID logo https://orcid.org/0000-0002-0773-5443
Park, Yong Beom(박용범)
Baek, Ji Hyeon(백지현)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Lee, Soo Kon(이수곤)
Jang, Hui Won(장희원)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
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