Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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A Case of Erythema Nodosum Associated with Mycoplasma pneumoniae Infection: Pathologic Findings and a Presumed Pathogenesis

마이코플라즈마 폐렴균 감염에 의한 결절성 홍반; 조직병리학적 소견과 병인론의 고찰

  • Ju, Hee Young (Department of Pediatrics, Kyung Hee University School of Medicine) ;
  • Kim, Gou Young (Department of Pathology, Kyung Hee University School of Medicine) ;
  • Choi, Sun Hee (Department of Pediatrics, Kyung Hee University School of Medicine)
  • 주희영 (경희대학교 의과대학 의학전문대학원 소아청소년과) ;
  • 김교영 (경희대학교 의과대학 의학전문대학원 병리과) ;
  • 최선희 (경희대학교 의과대학 의학전문대학원 소아청소년과)
  • Received : 2015.08.10
  • Accepted : 2015.10.06
  • Published : 2016.04.25
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Abstract

Erythema nodosum (EN) is a painful skin disease characterized by erythematous tender nodules located predominantly over the extensor aspects of the legs. Various etiological factors, including infection, drug administration, and systemic illness have been implicated as causes of EN. Mycoplasma pneumoniae is one of rare infectious agents to cause EN in children. We report a case of a 7-year-old boy with context of respiratory illness and skin lesions with arthralgia. From stepwise approaches, IgM antibody against M. pneumoniae was positive with titers of 12.18, consistent with respiratory infection of M. pneumoniae and histopathology showed findings of septal and lobular inflammation without vasculitis consistent with EN. In addition, we reviewed the pathogenesis of this disease based on our case and the previous reports.

결절성 홍반은 소아에서 가장 흔한 피하지방층의 염증으로 하지의 압통을 동반한 결절을 특징으로 한다. 이 질환은 다양한 원인에 의해 발생되지만 공통된 조직소견을 보여준다. 저자들은 임상적 소견 및 혈청학적 방법으로 마이코플라즈마 폐렴균에 의한 결절성 홍반을 진단하였고 조직병리적인 접근을 통해 결절성 홍반의 면역병인에 대해 고찰해 보았다. 조직병리소견은 제 4형 면역반응 염증을 보였으며 이는 다양한 원인에 의한 결절성 홍반의 발생 기전을 이해하는데 도움을 줄 것이다.

Keywords

References

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