Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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마이코플라즈마 감염에 의한 피부 병변을 동반하지 않은 Stevens-Johnson 증후군 1예

Mycoplasma pneumoniae-induced Stevens-Johnson syndrome without skin manifestations

  • 최선희 (경희대학교 의과대학 소아과학교실) ;
  • 이유민 (경희대학교 의과대학 소아과학교실) ;
  • 나영호 (경희대학교 의과대학 소아과학교실)
  • Choi, Sun-Hee (Department of Pediatrics, College of Medicine, Kyung Hee University) ;
  • Lee, Yu-Min (Department of Pediatrics, College of Medicine, Kyung Hee University) ;
  • Rha, Yeong-Ho (Department of Pediatrics, College of Medicine, Kyung Hee University)
  • 투고 : 2008.08.25
  • 심사 : 2008.10.09
  • 발행 : 2009.02.15
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초록

Stevens-Johnson 증후군은 피부에 특징적 발진과 수포를 동반하고 두 개 이상의 점막 조직에 병변을 보이는 것을 특징으로 하는 질환으로 감염, 예방 접종, 약물, 전신 질환 및 물리적 자극 등이 원인이 될 수 있다. 이 가운데 Mycoplasma pneumoniae는 소아기의 Stevens-Johnson 증후군의 가장 흔한 원인이다. 최근 Mycoplasma pneumoniae에 의한 피부 병변 없이 심한 점막의 병변만을 보이는 경우가 보고되었다. 이러한 경우를 피부 병변이 없는 Stevens-Johnson 증후군이거나 혹은 다른 개별적 질환으로 보아야 할지에 대해서는 아직 논란이 되고 있다. 병력에서 특이 사항이 없는 발열과 심한 경구 및 입술의 병변과 결막염으로 입원한 6세 남아가 임상 검사에서 Mycoplasma 항체 증가 이외에는 특이 소견을 보이지 않아 저자들은 Mycoplasma에 의한 피부병변 없는 Stevens-Johnson증후군으로 진단하였고 이를 문헌 고찰과 함께 보고하는 바이다.

Stevens-Johnson syndrome (SJS) presents with widespread blisters, erythematous or purpuric macules, and one or more mucous membrane erosions. Various etiologic factors, including infection, vaccination, drug administration, systemic diseases, physical agents, and food have been implicated as causes of SJS. Mycoplasma pneumoniae is the most common infectious agent to cause SJS in children. In recent literature, M. pneumoniae-induced SJS with mucositis that lacks the typical target lesions has been described. We report a case of a 6-year-old boy with swelling, peeling of the lips, and red eyes with photosensitivity. On physical examination, he showed severe oral mucositis and conjunctivitis with no evidence of skin lesions. Mycoplasma antibody, which was positive with titers of more than 1:2,560. For patients presenting with fever and mucositis of unknown origin, M. pneumoniae should be considered.

키워드

참고문헌

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피인용 문헌

  1. Mucosal Respiratory Syndrome: A Systematic Literature Review vol.238, pp.1, 2009, https://doi.org/10.1159/000514815