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Korean J Med > Volume 88(5); 2015 > Article
류마티스
The Korean Journal of Medicine 2015;88(5): 617-622.
강직성척추염의 악화로 오인된 장요근 농양
민재기1, 이경언1, 전성진1, 김인애1, 이상헌2, 김호연3, 김해림2,3
1건국대학교병원 내과
2건국대학교 의학전문대학원 내과학교실 류마티스내과
3건국대학교병원 류마티스내과
Iliopsoas Abscess Misconstrued as Aggravated Ankylosing Spondylitis
Jae Ki Min1, Kyoung Ann Lee1, Sung Jin Jeon1, In Ae Kim1, Sang-Heon Lee2, Ho-Youn Kim3, Hae-Rim Kim2,3
1Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
2Division of Rheumatology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
3Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
Corresponding Author: Hae-Rim Kim ,Tel: +82-2-2030-7542, Fax: +82-2-2030-7748, Email: kimhaerim@kuh.ac.kr
Received: November 18, 2014;   Revised: November 24, 2014;   Accepted: December 5, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
An iliopsoas abscess is a collection of pus in the iliopsoas muscle caused by the direct spread of infection from adjacent internal organs or by hematogenous or lymphatic spread from distal sites. Its symptoms are vague back, hip, thigh or lower abdomen pain with insidious onset, similar to those of ankylosing spondylitis (AS). Therefore diagnosing an iliopsoas abscess in patients with AS is difficult. A forty-three year-old man was treated with adalimumab, a tumor necrosis factor inhibitor, and clinical symptoms were subsequently observed to improve. One year after voluntary discontinuation of adalimumab, the patient returned with a recurrence of right buttock pain and was diagnosed as having aggravated AS. Following re-initiation of adalimumab, symptoms did not improve and fever developed. On the basis of imaging studies, the patient was diagnosed as having an iliopsoas abscess and was successfully treated with intravenous antibiotics.
Keywords: Iliopsoas abscess; Ankylosing spondylitis; Anti-tumor necrosis factor-alpha; Infection
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