강직성 척추염 환자에서 Infliximab 투여 후 헤노흐-쇤라인 자색반 1예

Abstract

Tumor necrosis factor alpha (TNF-α) inhibitors are used widely to treat patients with active rheumatoid arthritis and ankylosing spondylitis (AS). Although various cutaneous reactions can occur as side effects of TNF-α inhibitors, systemic vasculitis requiring withdrawal of the agent and immunosuppressive drugs is rare. A 59-year-old male with AS who had been treated with infliximab for 60 months visited us with complaints of palpable purpura on both legs and severe abdominal pain. Abdominal computed tomography showed diffuse wall thickening of the proximal jejunum and ileum and a skin biopsy revealed leukocytoclastic vasculitis. The patient was diagnosed with Henoch-Schönlein purpura (HSP). Infliximab was discontinued and systemic steroid therapy at 0.5 mg/kg resulted in prompt resolution of the HSP. Here, we report the first case of HSP in a patient with AS after infliximab treatment. (Korean J Med 2013;84:764-768) Keywords: Ankylosing spondylitis, Henoch-Schönlein purpura, Tumor necrosis factor-alpha inhibitor

저자들은 강직성 척추염 환자에서 infliximab을 사용한 이 후 발생한 헤노흐-쇤라인 자색반을 진단하고 약제 중단 및 스테로이드 요법으로 재발 없이 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다. 중심 단어: 강직성 척추염; 헤노흐-쇤라인 자색반; 인플릭 시맵