궤양성 대장염 환자에서 발생한 뇌경색 1예

• Published in: The Korean journal of medicine pp. 498 - 502
• Main Authors: 오종택, 전성우, 이응갑, 이순학, 정민규, 김성국
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.10.2009
• Subjects: 내과학
• ISSN: 1738-9364; 2289-0769

궤양성 대장염 환자에서 혈전증의 보고는 많으나 동맥 내 혈전증이 관찰된 경우는 매우 드물며, 이러한 합병증에 대한 명확한 치료지침도 없는 상태이다. 이에 저자들은 궤양성 대장염 환자에게서 발생한 뇌경색을 항혈소판제제인 클로피도그렐(clopidogrel)과 실로스타졸(cilostazol)을 투여하여 합병증 없이 치료한 경우를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Although cerebral thromboembolic disease is a rare extraintestinal manifestation of ulcerative colitis, it is one of the major causes of death in patients with the disease. A 29-year-old man who had a 7-year history of ulcerative colitis was admitted to our hospital complaining of nausea, vomiting, bloody diarrhea, and colicky abdominal pain. Fourteen days after admission, he developed sudden-onset left pure motor hemiplegia. Magnetic resonance imaging and angiography revealed an infarction involving the right temporo-occipital hemisphere and diffuse middle cerebral artery territory. Neck computed tomography angiography showed no evidence of cervical carotid or vertebral artery abnormalities, and transthoracic and transesophageal echocardiograms revealed no evidence of thrombi. Factor V was elevated to 176% (normal 50~150%) and protein S antigen had decreased to 57% (normal 60~150%). He was managed with antiplatelet agents and a total proctocolectomy. KCI Citation Count: 0