긴장성 동공으로 발현한 류마티스 관절염과 동반된 쇼그렌 증후군 1예

• Published in: The Korean journal of medicine pp. 261 - 264
• Main Authors: 고재기, 김진현, 류희정, 이은영, 이윤종, 이은봉, 송영욱
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.08.2009
• Subjects: 내과학
• ISSN: 1738-9364; 2289-0769

쇼그렌 증후군에서 신경병증이 발생하는 경우는 흔히 경험할 수 있지만, 쇼그렌 증후군에 의한 신경병증 중 삼차신경절의 섬모체신경절을 침범하여 긴장성 동공이 발생하는 경우는 매우 드물게 보고되었다. 저자들은 류마티스 관절염과 동반된 쇼그렌 증후군에서 신경계 침범에 의한 긴장성 동공이 발생하는 경우를 경험하여 보고하는 바이다. Sjögren’s syndrome is an autoimmune disease that presents mainly as dry eyes and mouth, and occasionally with extra-glandular symptoms. A peripheral neuropathy is present in 10~30% of the cases with extra-glandular symptoms, although a tonic pupil caused by destruction of the ciliary ganglion is rare. We report a case of rheumatoid arthritis with Sjögren’s syndrome presenting as a tonic pupil. A 29-year-old woman was admitted for evaluation of polyarthralgia and a tonic pupil. On physical examination, she had polyarthritis involving the jaws, shoulders, wrists, and hands. Her pupils were anisocoric and did not react to light, but constricted promptly to pilocarpine. Biopsy of the minor salivary gland showed lymphocyte infiltration. Rose-Bengal stain was positive. She was diagnosed with rheumatoid arthritis with Sjögren’s syndrome and treated with prednisolone and hydroxychloroquine. Three months later, her polyarthritis had improved markedly, but she still had a tonic pupil. KCI Citation Count: 1