Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A case of childhood relapsing/remitting multiple sclerosis and interferon β-1b treatment in a Korean patient

소아 재발/완화형 다발성 경화증 환자에서 인터페론 베타 1b 치료 1례

  • Kim, Hyun Seok (Department of Pediatrics, College of Medicine, Sungkyunkwan University Masan Samsung Hospital) ;
  • Lee, Won Deok (Department of Pediatrics, College of Medicine, Sungkyunkwan University Masan Samsung Hospital) ;
  • Lee, Jun Hwa (Department of Pediatrics, College of Medicine, Sungkyunkwan University Masan Samsung Hospital) ;
  • Cho, Kyung Lae (Department of Pediatrics, College of Medicine, Sungkyunkwan University Masan Samsung Hospital)
  • 김현석 (성균관대학교 의과대학 마산삼성병원 소아과) ;
  • 이원덕 (성균관대학교 의과대학 마산삼성병원 소아과) ;
  • 이준화 (성균관대학교 의과대학 마산삼성병원 소아과) ;
  • 조경래 (성균관대학교 의과대학 마산삼성병원 소아과)
  • Received : 2007.02.02
  • Accepted : 2007.04.15
  • Published : 2007.06.15
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Abstract

Multiple sclerosis (MS) is a demyelinating disorder that affects discrete areas of the CNS, including the optic nerves, in a quite variable relapsing-remitting fashion over a prolonged period of time. Although MS is usually considered to be a disease that affects peoples in early to middle adulthood, children do develop multiple sclerosis. The frequency of MS onset before the age of 15 years is 2.7-5% of all cases, while MS onset during infancy and early childhood was observed to be 0.2-0.7% of all cases. We report here on a Korean case of a relapsing-remitting MS female child who was treated with four rounds of intravenous methylpredinsolone pulse therapy and preventive Interferon-$\beta$-1b ($Betaferon^{(R)}$).

다발성 경화증은 중추신경계 백질의 여러 부위를 시간 간격을 두고 침범하는 만성재발성 질환이다. 주로 20세에서 40세 사이에 발병하며 15세 이하 소아에서도 3-5% 정도 발병하는 소아기에는 매우 드문 질환이다. 원인은 아직 정확히 밝혀지지 않았으나 유전적, 환경적 및 감염과 연관된 자가면역반응 등 여러요인이 복합적으로 작용하는 것으로 생각하고 있다. 임상증상은 침범된 백질 부위에 따라 다양한데 사지근력 약화나 저림, 시력장애, 감각장애, 운동실조 등 다양한 증세로 호전과 재발을 반복한다. 본 저자들은 경련, 왼쪽 편마비 등의 증상으로 6세에 첫 발병 후 메틸프레드니솔론(methylprednisolon) 치료 후 증상 완전 회복 있었으나 6개월 후 경련, 두통, 왼쪽 안와주위 통증 등으로 다시 입원하는 등 4년간 추적 관찰 중 4차례 메틸프레드니솔론 치료 실시하였으나 다른 양상의 신경학적 증상으로 재발하여 Interferon-${\beta}$-1b($Betaferon^{(R)}$, SheringAG, Germany) 예방 치료를 실시한 다발성 경화증 환자 1례를 경험 하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

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