직장-S상 결장접합부 거대 궤양을 통해 진단된 전신홍반 루푸스

• Published in: The Korean journal of medicine Vol. 82; no. 2; pp. 252 - 256
• Main Authors: 유인경, In Kyung Yoo, 유서희, Seu Hee Yoo, 최성재, Sung Jae Choi, 구자설, Ja Seol Koo, 이영호, Young Ho Lee, 지종대, Jong Dae Ji, 송관규, Kwan Kyu Song
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.02.2012
• Subjects: Ischemic colitis; Proctitis; Systemic Lupus erythematosus; 전신홍반루푸스; 직장 궤양; 허혈성 장염
• ISSN: 1738-9364

저자들은 비특이적인 위장 증상으로 내원한 전신홍반루푸스 환자에서 S상결장 부위의 부분-완전 폐색을 동반한 커다란 직장궤양을 발견하였고, 기저 질환으로 루푸스를 진단하고 경구스테로이드 치료로 호전되었기에 이를 보고하는 바이다. Systemic lupus erythematosus (SLE) is a multi-system inflammatory disorder that has many symptoms. Gastrointestinal symptoms are common, while colonic involvement in the form of ischemic colitis or a colonic ulcer is rare in SLE. The differential diagnosis of ischemic proctitis with ulceration includes an infected ulcer, ulcerative colitis, Crohn`s disease, solitary rectal ulcer colitis, malignant tumor, and lupus colitis. Here, we report a 22-year-old male with abdominal pain and diarrhea, who had a huge rectal ulcer that nearly obstructed the rectosigmoid junction. This turned out to be a rare gastrointestinal manifestation of lupus. He recovered after being treated with high-dose oral steroids. Our case demonstrates that a rectal ulcer is a rare, but important, complication of SLE and can be the initial clinical manifestation of the disease. (Korean J Med 2012;82:252-256)