A Case of Sjogren's Syndrome in a Patient with Hashimoto's Thyroiditis / 대한류마티스학회지

Sjogren's syndrome (SS)is a chronic,slowly progressive autoimmune disease characterized by lymphocytic infiltration of the exocrine glands leading to dry mouth and dry eyes accompanied by a variety of autoimmune phenomena. Despite the obvious difference in the affected organ,patients with SS and those with Hashimoto's thyroiditis share several histologic and genetic features.The immunopathologic findings of Hashimoto's thyroiditis and Sjogren's sialadenitis show similarities such as infiltration by activated T lymphocytes and inappropriate expression of HLA class II molecules by the epithelial cells.It has been reported that up to 50%of patients with SS develop autoimmune thyroid disease in the clinical course,and patients with Hashimoto's thyroiditis have symptoms related to SS frequently.In Korea,the ocurrence of SS in association with Hashimoto's thyroiditis has not been reported so far,although it is considered to coexist occasionally.We report a case of primary SS in a patient with Hashimoto's thyroiditis who had been treated with levothyroxine.

A Case of Calcium Pyrophosphate Dihydrate Crystal Deposition Disease Associated with Gout / 대한류마티스학회지

Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease has various patterns of clinical manifestation ranging from an absence of symptoms to a severely destructive arthropathy. A number of metabolic diseases and physiologic stresses, such as aging and trauma, have been associated with CPPD crystal deposition. The coexistence of CPPD crystal deposition disease and gout varies from 2 to 8%. The mechanism of this association has been postulated to be a predisposition to the local deposition of pyrophosphate due to the presence of urate crystal, perhaps acting as a nucleating agent or factor which predispose to the deposition of both kinds of crystals. In Korea, although it is considered that CPPD crystal deposition occasionally coincides monosodium urate crystal, it has not been reported so far. We report a case with CPPD crystal deposition disease combined with gout in a patient who has suffered from osteoarthritis, which is diagnosed by polarized microscopic examination of synovial fluid.

A Case of Acute Acalculous Cholecystitis in a Patient with Systemic Lupus Erythematosus / 대한류마티스학회지

Several gastrointestinal complications have been reported in association with systemic lupus erythematosus (SLE),including mesenteric vasculitis,bowel perforation,gastric or duodenal ulcer,necrotizing enterocolitis,spontaneous peritonitis,pancreatitis,spontaneous rupture of the liver or spleen and hepatomegaly.Acute acalculous cholecystitis is a rare disease that occurs in only 5~10%of patients with acute cholecystitis,typically in seriously ill patients. Reports of gallbladder diseases in patients with SLE are very scarce.Only seven cases of SLE complicated with acalculous cholecystitis have been reported so far, but not in Korea.Six cases were treated surgically by cholecystectomy or cholecystostomy,and one case was treated without surgical intervention.We added a case in which acute acalculous cholecystitis accompanying SLE was treated successfully by corticosteroid without surgical intervention.