The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Symmetrical Peripheral Gangrene Complicating Escherichia coli Sepsis Associated with Antiphospholipid Antibodies in Lupus Nephritis

루푸스 신염 환자에서 항인지질 항체와 연관된 감염 후 칭적 말초 괴저

  • Lee, Jae Sung (Department of Internal Medicine, Seoul Red Cross Hospital) ;
  • Seong, Jee Seok (Department of Internal Medicine, Seoul Red Cross Hospital) ;
  • Woo, Yong Moon (Department of Internal Medicine, Seoul Red Cross Hospital) ;
  • Cho, Young Jun (Department of Internal Medicine, Seoul Red Cross Hospital) ;
  • Jeong, Beom Jin (Department of Internal Medicine, Seoul Red Cross Hospital) ;
  • Kang, Han Na (Department of Pathology, Seoul Red Cross Hospital) ;
  • Kim, Su-Jung (Division of Public Health Medical Service, Seoul National University Hospital, Seoul University College of Medicine)
  • 이재성 (서울적십자병원 내과) ;
  • 성지석 (서울적십자병원 내과) ;
  • 우용문 (서울적십자병원 내과) ;
  • 조영준 (서울적십자병원 내과) ;
  • 정범진 (서울적십자병원 내과) ;
  • 강한나 (서울적십자병원 병리과) ;
  • 김수정 (서울대학교 의과대학 서울대학교병원 공공보건의료사업단)
  • Received : 2013.12.03
  • Accepted : 2014.03.04
  • Published : 2014.09.01
⟨ Previous Next ⟩

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disease that involves vascular thrombosis and pregnancy morbidity associated with elevated titers of antiphospholipid antibodies. APS can affect any organ and has a variety of clinical manifestations. Infections can be associated with thrombotic events in APS, including the potentially fatal subset catastrophic APS. We report a case of extensive symmetrical peripheral gangrene complicating Escherichia coli sepsis associated with antiphospholipid antibodies in a patient with lupus nephritis.

저자들은 요로감염 패혈증 후 다발성 장기부전을 보인 루푸스 신염 환자에서 항인지질 항체와 연관된 광범위한 대칭적 말초 괴저를 경험하였고 항생제와 고용량 prednisolone, 항응고제 사용으로 호전시킨 1예를 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Lim W. Antiphospholipid antibody syndrome. Hematology Am Soc Hematol Educ Program 2009:233-239.
  2. Tsuruta Y, Uchida K, Itabashi M, Yumura W, Nitta K. Antiphospholipid antibodies and renal outcomes in patients with lupus nephritis. Intern Med 2009;48:1875-1880. https://doi.org/10.2169/internalmedicine.48.2363
  3. Grob JJ, Bonerandi JJ. Thrombotic skin disease as a marker of the anticardiolipin syndrome: livedo vasculitis and distal gangrene associated with abnormal serum antiphospholipid activity. J Am Acad Dermatol 1989;20:1063-1069. https://doi.org/10.1016/S0190-9622(89)70133-X
  4. Cervera R, Asherson RA, Acevedo ML, et al. Antiphospholipid syndrome associated with infections: clinical and microbiological characteristics of 100 patients. Ann Rheum Dis 2004;63:1312-1317. https://doi.org/10.1136/ard.2003.014175
  5. Ghosh SK, Bandyopadhyay D. Symmetrical peripheral gangrene. Indian J Dermatol Venereol Leprol 2011;77:244-248. https://doi.org/10.4103/0378-6323.77481
  6. Parmar MS. Symmetrical peripheral gangrene: a rare but dreadful complication of sepsis. CMAJ 2002;167:1037-1038.
  7. Son KM, Lim SK, Jeon EY, Kim HA, Seo YI. A case of systemic lupus erythematosus diagnosed by initial presentation of digital gangrene. Korean J Med 2013;84:141-144. https://doi.org/10.3904/kjm.2013.84.1.141
  8. Lee HY, Jang JS, Kim HW, Kim YS, Kim YO, Yoon SA. A case of digital gangrene complicated by atypical hemolytic uremic syndrome in a patient with systemic lupus erythematosus. Korean J Nephrol 2010;29:392-397.
  9. Moroni G, Ventura D, Riva P, et al. Antiphospholipid antibodies are associated with an increased risk for chronic renal insufficiency in patients with lupus nephritis. Am J Kidney Dis 2004;43:28-36. https://doi.org/10.1053/j.ajkd.2003.09.011
  10. Choi YS, Kim YO, Jo JH, et al. Acute renal failure and ischemic bowel disease complicated by acute pyelonephritis in a patient with systemic lupus erythematosus. Korean J Nephrol 2000;19:740-744.