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A Case of Neuromyelitis Optica with Paraneoplastic Syndrome in Hepatocellular Carcinoma
±æÇö°æ ( Kil Hyun-Kyung ) - ºÐ´çÁ¦»ýº´¿ø ¾È°ú
À̱¸Àº ( Lee Ku-Eun ) - ºÐ´çÁ¦»ýº´¿ø ½Å°æ°ú
È«ÇõÁø ( Hong Hyeok-Jin ) - ºÐ´çÁ¦»ýº´¿ø ¿µ»óÀÇÇаú
¹Ú»óÁ¾ ( Park Sang-Jong ) - ºÐ´çÁ¦»ýº´¿ø ¼Òȱ⳻°ú
½Å»ó°Ç ( Shin Sang-Kun ) - ½Å»ó°Ç½Å°æ°ú
Abstract
¸ñ Àû: °í·ÉÀÇ °£¾Ï ȯÀÚ¿¡¼ ¹æÁ¾¾ç¼º ÁõÈıºÀ¸·Î ¹ß»ýÇÑ ½Ã½Å°æÃ´¼ö¿°(Devic ÁõÈıº) ȯÀÚ¸¦ °æÇèÇÏ¿´±â¿¡ º¸°íÇϰíÀÚ ÇÑ´Ù.
Áõ·Ê¿ä¾à: °£¾ÏÀ¸·Î Ä¡·á ¹Þ°í ÀÖ´Â 70¼¼ ³²ÀÚ È¯ÀÚ°¡ ³»¿ø 5ÀÏÀü ¹ß»ýÇÑ µÎ ´«ÀÇ ±Þ°ÝÇÑ ½Ã·Â ¼Ò½ÇÀ» ÁÖ¼Ò·Î ³»¿øÇÏ¿´´Ù. µÎ ´«ÀÌ »êµ¿ µÈ »óÅ·Π½Ã·ÂÀº ¿ì¾È ±¤°¢ ¾øÀ½, ÁÂ¾È ¾ÈÀü ¼öµ¿À̾úÀ¸¸ç ³úÀÚ±â°ø¸í¿µ»ó¿¡¼ ƯÀÌ ÀÌ»ó ¼Ò°ßÀº ¾ø¾úÀ¸³ª ôÃß ÀÚ±â°ø¸í¿µ»ó¿¡ ¼´Â ½ÉÇÑ Ã´¼ö¿° ¼Ò°ßÀ» º¸¿´´Ù. °í¿ë·® methylprednisolone Ä¡·á ÈÄ ¿ì¾È 0.03, ÁÂ¾È ¾ÈÀü ¼öÁö 30 cm·Î ȸº¹µÇ¾ú´Ù.
°á ·Ð: ÀúÀÚµéÀº °£¾ÏȯÀÚ¿¡¼ ¹æÁ¾¾ç¼º ÁõÈıºÀ¸·Î ¹ß»ýÇÑ ½Ã½Å°æÃ´¼ö¿°À» °æÇèÇÏ¿´±â¿¡ À̸¦ º¸°íÇϰíÀÚ ÇÏ¿´´Ù. ¶ÇÇÑ ¿øÀÎÀ» ¾Ë ¼ö ¾ø´Â ½Ã½Å°æº´ÁõÀÌ ÀÖ´Â °æ¿ì¿¡ Àü½ÅÀûÀÎ ÀÌÇÐÀû °Ë»ç°¡ ÇÊ¿äÇÒ ¼ö ÀÖÀ¸¸ç ½Ã½Å°æº´ÁõÀÇ ¿©·¯ ¿øÀÎ ÁßÀÇ Çϳª·Î ½Ã½Å°æÃ´¼ö¿°À» °í·Á ÇØ¾ß ÇÒ °ÍÀ¸·Î »ý°¢ÇÑ´Ù.
Purpose: We report a case of neuromyelitis optica (Devic¡¯s syndrome) with hepatocellular carcinoma.
Case summary: A 70?year?old male with hepatocellular carcinoma presented with bilateral visual loss. A relative afferent pupillary defect was not observed in either eye due to bilateral mydriasis. On brain MRI, there was no specific finding, however, on spine MRI, multiple and severe myelopathies were observed. After high?dose methylprednisolone pulse therapy, the visual acuity was 0.03 in the right eye and counting fingers at 30 cm in the left eye.
Conclusions: We encountered a case of neuromyelitis optica involving bilateral optic neuropathy in hepatocelluar carcinoma. Therefore, in patients with an optic neuropathy of uncertain etiology, clinicians should consider performing a systemic evaluation.
Ű¿öµå
Devic¡¯s syndrome; Hepatocellular carcinoma; Neuromyelitis optica; Optic neuritis
KMID :
0360220130540101630
DOI :
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