A Case Report of Systemic Type Juvenile Rheumatoid Arthritis with Fever and Eruption

고열, 발진을 동반하는 전신형(systemic) 소아기 류마티스 관절염(juvenile rheumatoid arthritis; JRA) 환아 증례 1례 보고

  • Published : 2009.04.30

Abstract

Objectives This study is to report a case that has an important meaning as a result of treating Juvenile Rheumatoid Arthritis. We investigated a patient who had to maintain his life with western medicines such as DMARDs, NSAIDs and steroids for a long time. The patient has recovered from all symptoms and his ESR, CRP has been back to normal range with oriental medicine treatment. Methods The patient had fever, especially repeated fever during the afternoon, pain and swelling of joints, generalized skin eruption, anorexia, delayed growth, weight loss, fatigue. So we treated him with herbal medicine and reduced his western medicine. The aim of treatment was recovery from Juvenile Rheumatoid Arthritis after discontinuance of all western medicine. Results The symptoms of systemic type Juvenile Rheumatoid Arthritis was vanished and the patient maintains his condition with oriental medicine treatment after stopped all DMARDs such as MTX(methotrexate) and NSAIDs. His ESR and CRP levels were back to the normal range. After this treatment the patient's height and weight has been increased which showed a significant meaning in growth to the child. Conclusions This study showed that oriental medicine can elevate the Juvenile Rheumatoid Arthritis patient's quality of life with continuous health care and treatment for major problem. For more accurate studies, further studies would be needed with more cases.

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References

  1. 임상류마티스학 편찬위원회. 임상류마티스학. 제1판. 서울:도서출판 한국의학사. 2006:292-309.
  2. Fink CW, and the Task Force for Classification Criteria. Proposal for the development of classification crireia for idiopathic arthritides of childhood. J Rheumatol. 1995;22:1566.
  3. Petty R, Southwood TR, Baum J, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol. 1998;25:1991-4.
  4. 한방재활의학과학회. 한방재활의학. 서울:군자출판사. 2005:78-99.
  5. 최진봉 외. 소아 류마토이드 관절염 환자에 대한 임상적 고찰. 한방재활의학과학회지. 1998:306.
  6. Oen KG, Cheang M. Epidemiology of chronic arthritis in childhood. Semin Arthritis Rheum. 1996;26:575-91. https://doi.org/10.1016/S0049-0172(96)80009-6
  7. Woo P. The cytokine network in juvenile chronic arthritis. Ann Med. 1997;29:145-7. https://doi.org/10.3109/07853899709113701
  8. De Benedetti F, Massa M, Pignatti P, et al. Serum soluble interleukin 6(IL-6) receptor and IL-6/soluble IL-6 receptor complex in systemic juvenile rheumatoid arthritis. J Clin Invest.1994;93:2114-9. https://doi.org/10.1172/JCI117206
  9. European League Against Rheumatism: EULAR Bulletin No. 4. Nomenclature and Classification of Arthritis in Children. Basel, National Zeitung AG. 1977.
  10. Fink CW, and the Task Force for Classification Criteria. Proposal for the develpment of classification criteria for idiopathic arthritides of childhood. J Rheumatol. 1995;22;1566.
  11. Keystone EC. The role of tumor necrosis factor antagonism in clinical practice. J Rheumatol. 1999;26(Suppl):22-8. https://doi.org/10.1093/rheumatology/26.1.22
  12. Tyndall A. Gratwohl A. Bone marrow transplantation in the treatment of autoimmune diseases. Br J Rheumatol. 1997:36:1-3. https://doi.org/10.1093/oxfordjournals.rheumatology.a031442
  13. 張仲景. 仲景全書. 서울:大成文化社. 1984: 165-66,156-57.
  14. 吳有性. 溫疫論補註(下). 上海:晋及書局. 1975:24.
  15. 周命新. 醫門寶鑑, 서울:三協出版社, 1964:17.
  16. 王 壽. 外臺秘要(上). 서울:成補社. 1975:55.
  17. 康命吉. 濟衆新編. 서울:杏林書院. 1975:12.
  18. 尹吉榮. 東醫臨床方劑學, 서울:明費出版社. 1985:161-79,185-97.
  19. 蔡仁植. 傷寒論譯詮. 서울:高文社. 1985: 456-61,481-2.
  20. 許 竣. 東醫寶鑑. 서울:南山堂. 1981:395, 82.
  21. 黃道淵. 方藥合編. 서울:南山堂. 1983:129-130,134,151.
  22. 徐大春. 徐靈胎醫書三十二種(下). 서울: 慶熙大學校醫科大學 韓醫學科. 1974:1181.
  23. 孫思邈. 千金翼方. 臺北:中國醫藥硏究所. 1966:101.
  24. 李 遷. 醫學入門. 서울:南山堂. 1984: 427-8,430.
  25. 具本弘. 消化器疾患의 韓方 臨床. 서울:杏林出版社. 1977;232-40,249.259.
  26. 金定劑, 金秉雲. 東醫肝系內科學. 서울:東洋醫學硏究員. 1978:12,17,21,23.
  27. 金周德, 金聖光譯. 免疫學入門. 서울:醫齒學社. 1983:217-24
  28. 李文鎬. 內科學(上). 서울:博愛出版社. 1976:1240-6.
  29. 두호경 외. 小柴胡湯合四苓散이 $HgCl_2$ 로 중독된 실험동물 손상신의 면역반응 및 이뇨에 미치는 영향에 관한 연구. 경희의학. 1989;5(2):158-67
  30. 全國韓醫科大學 四象醫學敎室. 四象醫學. 서울:집문당. 1998:478.