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A Case of Sarcoidosis Presented as Multiple Conjunctival and Nasal Mucosal Nodule

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À¯ÀÎõ ( You In-Cheon ) - ÀüºÏ´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç

¹®ÇüÁø ( Moon Hyung-Jin ) - Àü³²´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç
¹®±ÍÇü ( Mun Gwi-Hyeong ) - Àü³²´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç
ÀÓ»óö ( Lim Sang-Chul ) - Àü³²´ëÇб³ Àǰú´ëÇÐ À̺ñÀÎÈİúÇб³½Ç
À±°æÃ¶ ( Yoon Kyung-Chul ) - Àü³²´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç

Abstract

¸ñÀû:»ç¸£ÄÚÀ̵åÁõÀº ´Ù¾çÇÑ Àå±â¸¦ ħ¹üÇÏ´Â ºñ°Ç¶ôÀ°¾ÆÁ¾¼º ¿°ÁõÁúȯÀ¸·Î °áÇÙ°ú À¯»çÇÏ¿© ÀÓ»óÀûÀ¸·Î °¨º°Çϱ⠾î·Á¿î °æ¿ì°¡ ¸¹´Ù. ºñÁ¡¸·ÀÇ ´Ù¹ß¼º °áÀý¿¡ ´ëÇÏ¿© °áÇÙ Ä¡·á¸¦ ¹Þ´ø Áß ´Ù¹ß¼º °á¸· °áÀýÀÌ ¹ß»ýÇÏ¿© ¾È°úÀû ¹× Àü ½Å °Ë»ç¸¦ ½ÃÇàÇÑ °á°ú »ç¸£ÄÚÀ̵åÁõÀ¸·Î Áø´ÜµÈ 1¿¹¸¦ º¸°íÇÏ´Â ¹ÙÀÌ´Ù.

Áõ·Ê¿ä¾à :37¼¼ ¿©ÀÚ È¯ÀÚ°¡ ºñÁ¡¸·ÀÇ ´Ù¹ß¼º °áÀý·Î °áÇÙÄ¡·á¸¦ 9°³¿ù°£ ¹Þ´ø Áß Á¾ÈÀÇ ÃæÇ÷°ú ´Ù¹ß¼º °á¸· ÀÛÀº °áÀýÀ» ÁÖ¼Ò·Î ³»¿øÇÏ¿´´Ù. ÀÌÇÐÀû °Ë»ç»ó Á¾ÈÀÇ »ó, ÇÏ °á¸·¿¡ ´Ù¹ß¼ºÀÇ ³ë¶õ»öÀ» ¶ç´Â ÀÛÀº°áÀýÀÌ ÀÖ¾î »ý°Ë°ú µ¿½Ã ¿¡ Àü½ÅÀûÀÎ °Ë»ç¸¦ ½ÃÇàÇÏ¿´´Ù. º´¸®ÇÐÀû °Ë»ç»ó ºñ°Ç¶ôÀ°¾ÆÁ¾¼º ¿°Áõ ¼Ò°ßÀ» º¸¿´°í Ç÷û ACE (angiotensin converting enzyme) Áõ°¡¿Í ¼Òº¯ÀÇ Ä®½· Áõ°¡ ¹× ÈäºÎÀü»êÈ­´ÜÃþÃÔ¿µ»ó Æó¹®ºÎ ¹× Á¾°Ýµ¿ Àӯļ± Áõ´ë ¼Ò°ßÀ» º¸¿© »ç¸£ÄÚÀ̵åÁõ°ú ÇÕ´çÇÑ °á°ú¸¦ º¸¿´´Ù. ´Ù¹ß¼º °á¸· °áÀý¿¡ ´ëÇÏ¿© °á¸·ÇÏ ½ºÅ×·ÎÀ̵带 ÁÖ»çÇÏ¿´°í Àü½ÅÀûÀÎ ½ºÅ×·ÎÀÌ µåÀÇ º¹¿ëÀ¸·Î ¾È°ú ¹× Àü½Å Áõ¼¼ÀÇ È£ÀüÀ» º¸¿´´Ù.

°á·Ð: °á¸·°ú ºñÁ¡¸·ÀÇ ¸¸¼ºÀûÀÎ ´Ù¹ß¼º °áÀýÀÌ ÀÖÀ»½Ã »ç¸£ÄÚÀ̵åÁõÀÇ °¡´É¼ºÀ» ¿°µÎ¿¡ µÎ¾î¾ß ÇÒ °ÍÀÌ´Ù.

urpose:Sarcoidosis is a noncaseating granulomatous disorder that can affect any organ. In its early phase, sarcoidosis is clinically similar to tuberculosis. We report a case of sarcoidosis diagnosed through ocular and systemic evaluations in a patient who developed multiple conjunctival nodules during antituberculous treatment for nasal mucosal nodules.
Case summary: A 37-year-old woman who had been on antituberculosis medications for 9 months because of multiple nasal mucosal nodules was referred for conjunctival hyperemia and the multiple nodules. The ocular examination revealed multiple conjunctival nodules in the upper and lower fornices. Biopsy and systemic evaluations were performed. A conjunctival biopsy specimen showed noncaseating granulomatous inflammation compatible with sarcoidosis. Laboratory tests revealed hypercalciuria and increased levels of ACE. Chest computed tomography showed bilateral hilar and mediastinal lymphadenopathy. Subconjunctival steroid injection was done for the conjunctival nodules and systemic steroid treatment was started as well. Complete resolution of conjunctival lesions was obtained.

Conclusions: In cases of chronic, multiple conjunctival and nasal mucosal nodules, sarcoidosis should be considered in the differential diagnosis.

Ű¿öµå

Conjunctiva; Corticosteroid; Nasal mucosa; Sarcoidosis
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