Performance Evaluation of Public Hospital Information Systems by the Information System Success Model / 대한의료정보학회지

OBJECTIVES: This study was to evaluate the performance of the newly developed information system (IS) implemented on July 1, 2014 at three public hospitals in Korea. METHODS: User satisfaction scores of twelve key performance indicators of six IS success factors based on the DeLone and McLean IS Success Model were utilized to evaluate IS performance before and after the newly developed system was introduced. RESULTS: All scores increased after system introduction except for the completeness of medical records and impact on the clinical environment. The relationships among six IS factors were also analyzed to identify the important factors influencing three IS success factors (Intention to Use, User Satisfaction, and Net Benefits). All relationships were significant except for the relationships among Service Quality, Intention to Use, and Net Benefits. CONCLUSIONS: The results suggest that hospitals should not only focus on systems and information quality; rather, they should also continuously improve service quality to improve user satisfaction and eventually reach full the potential of IS performance.

Developing the Hardtack Test to Screen and Monitor the Sjogren's Syndrome in Korea / 대한류마티스학회지

OBJECTIVE: To investigate the usefulness of the Hardtack test to screen the Sjogren's syndrome compared with non-stimulated whole salivary flow (NSWSF) and Schirmer-1 test. METHODS: Fifty patients with RA and other connective tissue disease who had complained sicca symptoms (7 males and 43 females) and twenty healthy participant, were undergone the Hardtack test, NSWSF, and Schirmer-1 test. The Hardtrack test were compared with NSWSF and Schirmer-1 test for the screening of Sjogren's syndrome. And the relationship between the tests were evaluated. RESULTS: 1) The time of dissolution of the hardtack was 88.7sec (Max: 136, Min: 44) in healthy group, and 321 sec (Ma: 900, Min: 92) in patient group (p<0.001). 2) NSWSF was 0.6 ml/min (Max: 1.32, Min: 0.14) in healthy group, and 0.28 ml/min (Max: 0.8, Min: 0.01) in patient group (p<0.001). 3) The lacrimal flow in Schirmer-1 test was 22.0 mm (Max: 30, Min: 8) in healthy groups and 5.26 mm (Max: 21, Min: 0) in patient group (p<0.001). 4) The correlation coefficient between the hardtack test and NSWSF was 0.56 (p<0.001). The correlation coefficient between the hardtack test and Schirmer-1 test was 0.51 (p<0.001). NSWSF was correlated with Shirmer-1 test but not significantly (r=0.254, p=0.075). In the hardtack test, the best balance between sensitivity and specificity was seen with a cut-off value of 120 seconds. CONCLUSION: The Hardtack test is useful screening test to discriminate between subjects with normal and reduced salivary flow. The Hardtack test is easy to perform, inexpensive, imposes minimal discomfort on the subject with xerostomia and correlated well with the NSWSF and the Schirmer-1 test. So it can also be used as to monitor the Sjogren's syndrome before the salivary flow measurement or Schirmer-1 test.

The Comparison of the Efficacy and Adverse Drug Reaction ofCelecoxib and Diclofenac in the Treatment of Osteoarthritis in Korean Multicenter Trial / 대한류마티스학회지

OBJECTIVE: Long-term use of the analgesic acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis is limited due to the lack of effectiveness and presence of side effects. Celecoxib is a selective inhibitor of cyclo-oxygenase (COX)-2 and expected to help NSAIDs in expressing the effective anti-inflammatory effect by not inhibiting COX-1. Thus, 200 mg of celecoxib and 100 mg of slow releasing diclofenac were compared for their effectiveness and safety in Korean patients with knee osteoarthritis. METHODS: We administered 200 mg of celecoxib or 100 mg of slow releasing diclofenac in 223 randomly selected patients with knee osteoarthritis for 4 weeks. The effectiveness of these drugs on osteoarthritis was assessed by evaluating pain in each patient, making overall evaluation on osteoarthritis by the patient and his/her attending physician, and measuring the severity indices on osteoarthritis before treatment, and 2 weeks and 4 weeks after treatment. Moreover, safety and drug resistance were evaluated by assessing the rate of adverse effects, rate of withdrawal, laboratory tests, and vital signs. RESULTS: The clinical symptoms of osteoarthritis were improved significantly by 4 weeks after treatment with celecoxib and diclofenac. According to the results of overall evaluation made by attending physicians 2 weeks after treatment, the rate of improvement was 49.5% in celecoxib group and 35.7% in diclofenac group, showing a statistically significant difference (p=0.023). Other than this difference, no other significant difference was present between the two groups with other variables used for the evaluation of effectiveness. The rate of adverse effects was significantly lower in celecoxib group compared with diclofenac group. According to laboratory findings, no abnormal figure was found in both groups but total bilirubin, SGOT, and SGPT were consistently higher in patients in diclofenac group. Thirteen patients dropped out of the study due to side effects (10 patients) and treatment failure (3 patients). CONCLUSION: Our findings from the clinical comparison of celecoxib and diclofenac in Korean patients with knee osteoarthritis were similar to those results found in previous studies. Although celecoxib showed similar effectiveness as diclofenac on knee osteoarthritis in the treatment of symptoms, it showed a lower rate of adverse effects; thus, we concluded that celecoxib is safer compared with diclofenac.

Musculoskeletal manifestations and factors elevating hepatic enzyme in patients with hepatitis B and C viral infection / 대한내과학회지

BACKGROUND: To investigate the musculoskeletal manifestations and factors aggravating hepatic enzyme in patients with hepatitis B (HBV) and C (HCV) viral infection. METHODS: Eighty seven patients with HBV (72 patients) and HCV (15 patients) infection complaining of musculoskeletal symptoms were investigated retrospectively. RESULTS: Extrahepatic manifestations of patients with hepatitis viral infection were arthralgia/ arthritis (77%/72%), dermatologic manifestations(16%), neurologic manifestations (11%), and constitutional symptoms (6%). The kinds and the incidence of extrahepatic symptoms were not different between two viral infections. The rheumatologic diagnosis of patients with hepatitis viral infection were RA (41%), fibromyalgia (13%), Sj gren's syndrome (7%), SLE (5%), sacroiliitis (5%), Behcet's disease (5%), carpal tunnel syndrome (3%), and unclassified arthritis (32%). The diagnosis were not different between the two groups. There was no association of the hepatitis viral infection with any specific rheumatic disease. The patterns of arthritis were polyarthritic (79%), oligoarthritic (16%), and monoarthritic (5%) and the involvement sites were peripheral (89%), root (38%), and axial(29%). The involvement of root joint in patients with HBV (41%) infection was more frequent than HCV (22%) infection (p<0.05). The involvement of axial and peripheral joint was not different between the two groups. The prevalence of rheumatoid factor and anti-nuclear antibody were 48% and 21% in patients with hepatitis viral infection respectively. Patients taking steroid, hydroxychloroquine, bucillamine, or combined disease modifying antirheumatic drugs (DMARDs) tended to have aggravated hepatic enzyme level (p<0.05). CONCLUSION: The patients with hepatitis viral infection showed various musculoskeletal manifestations without relation to any specific rheumatic disease. The patients with HBV infection had more involvement in root joint than HCV infection. The steroid, hydroxychloroquine, bucillamine, or combined DMARDs were related to aggravated hepatic enzyme.

Acute Respiratory Failure Derived From Subglottic Stenosis in a Patient with Relapsing Polychondritis / 결핵

Relapsing polychondritis (RP) is rare, chronic, relapsing, and multisystemic inflammatory disease targeting the cartilaginous structures. Respiratory track involvement occurs in approximately half of the cases. Subglottic stenosis is a rare manifestation of RP. Here, we report a case of RP with a subglottic stenosis, resulting in acute respiratory failure. A 63-year old man was admitted complaining of multiple joint pain, general weakness, weight loss, throat pain, hoarseness, exertional dyspnea, and hearing difficulties. A laryngoscopy and neck CT revealed a subglottic stenosis. Four days after admission, he complained severe dyspnea resulting in acute respiratory failure. Immediately, a tracheostomy was done for airway preservation. After high dose steroid therapy, the general symptoms were improved. However, the subglottic stenosis was sustained. Thus, a laryngotracheal augumentation and stent insertion was performed. The speech valve was then replaced. The subglottic stenosis was managed with low dose steroid and monthly cyclophosphamide pulse therapy, and the patients has been followed up regularly.

A Case of Hypothermia Combined with Systemic Lupus Erythematosus

Systemic lupus erythematosus(SLE) is a prototypic autoimmune disease affecting various organ systems. Hypothermia is a rare manifestation of SLE. We experienced a case of SLE combined with hypothermia. A 36-year-old woman, who had been diagnosed as SLE 3 days before admission, admitted complaining of mental confusion. After admission, her body temperature, initially 36.1 degree C, became 32.6 degree C. Her core body temperature was less than 35.0 degree C. Despite of warming with heating lamp and blankets, her core temperature did not reach 35.0 degree C during 18 hours. Ten days later, her temperature exceeded 36.0 degree C.

The Usefulness of Serum Transferrin Receptor in Anemia with Rheumatoid Arthritis: Comparison with Bone Marrow Iron Store / 대한류마티스학회지

OBJECTIVE: This study was aimed at investigating the usefulness of serum transferrin receptor (sTfR) in anemic patients with rheumatoid arthritis (RA) compared with bone marrow storage iron and other tests for anemia. METHODS: Fifty-five anemic RA patients were undergone anemia study including hematologic indices, iron panel, and sTfR. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured. Eighteen patients performed marrow iron stain. The sTfR and serum ferritin levels were compared with bone marrow iron store, hematologic values, iron batteries, and markers of the disease activity. RESULTS: 1) Mean sTfR concentration was 2.68+/-1.29mg/L in all patients. 2) sTfR correlated significantly with hemoglobin concentration (r=-0.491; p<0.001), hematocrit (r=-0.348; p=0.009), MCV (r=-0.597; p<0.001), RDW (r=0.696; p<0.001), serum iron (r=-0.389; p=0.003), and transferrin saturation (r=-0.451; p=0.001) 3) Ferritin did not correlated significantly with hemoglobin, hematocrit, serum iron/TIBC, MCV and RDW, except reticulocyte count (r=0.295; p=0.032) and total iron binding capacity (TIBC) (r=-0.503; p<0.001). 4) sTfR showed no significant correlation with ESR and CRP, whereas ferritin correlated with CRP (r=0.342; p=0.019). 5) Among the patients who performed iron staining from bone marrow, sTfR was higher in ?ron-depleted? group compared with ?ron replete? group (p=0.040). CONCLUSION: This study suggests that measurement of sTfR may be useful assay for anemia and the possible substitute for invasive bone marrow study in differentiating iron deficiency anemia from anemia of chronic diseases in patients with RA.

1H-Magnetic Resonance Spectroscopy for The Early Diagnosis of Neuropsychiatric Systemic Lupus Erythematosus / 대한류마티스학회지

OBJECTIVE: To investigate the usefulness of 1H-magnetic resonance spectroscopy (1H-MRS) for the early diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE). METHODS: Magnetic resonance image (MRI) and 1H-MRS were performed on fifteen normal volunteers (mean age, 29+/-6 years; age range, 24~40 years) and twenty seven patients with SLE: twelve (26+/-8 years; 16~42 years) with and fifteen (32+/-12 years; 13~57 years) without NPSLE. The localized 1H-MRS was performed by a GE 1.5T SIGNA MRI/MRS system (version 5.5) with active shielded gradients. For all spectra, a Stimulated Echo Acquisition Method (STEAM) localization sequence with three-pulse CHESS H2O suppression was used. The metabolite ratios of N-acetylaspartate (NAA) to creatine (Cr) and choline (Cho) to Cr measured on 1H-MRS of the basal ganglia (BG) and peritrigonal periventricular white matter (PWM). RESULTS: The level of disease activity makers (anti-dsDNA, C3, C4, SLEDAI score), autoantibodies (lupus anticoagulant, anticardiolipin antibody, antiribosomal-P), and EEG did not showed significant difference between the patients without NPSLE and with NPSLE (p>0.05). Thirteen percent (2/15) of patients without NPSLE and fifty percent (6/12) of patient with the NPSLE showed abnormality in MRI. 1H-MRS showed significantly decreased NAA/Cr ratio in BG and increased Cho/Cr ratio in PWM for the patients with NPSLE compared to the patients without NPSLE and normal volunteers (p0.05). But negative correlation was shown between NAA/Cr in BG and Cho/Cr ratio in PWM (r=-0.58, p<0.05). CONCLUSION: NAA/Cr ratio in BG was decreased and Cho/Cr in PWM was increased in NPSLE. The neurometabolite ratio measured by 1H-MRS may be useful in the early detection of NPSLE.

A Case of Crohn? Disease Associated with Pyoderma Gangrenosum and Peripheral Arthritis / 대한류마티스학회지

The Crohn? disease is a inflammatory bowel disease and it? symptoms are nonspecific. The extraintestinal manifestations of Crohn? disease are arthritis, pericholangitis, erythema nodosum, pyoderma gangrenosum, uveitis, episcleritis, and miscellaneous. Arthritic manifestations caused by Crohn? disease belong to seronegative spondyloarthropathies and are divided into peripheral arthritis, spondylitis, and sacroiliitis. And peripheral arthritis in Crohn? disease usually worsen with exacerbation of bowel inflammation but pyoderma gangrenosum, the most severe skin lesion, bears little relationship to the activity or extent of the colitis. A 53 year-old man presented peripheral arthritis on multiple joints and necrotizing ulcerative skin lesion on abdomen and left knee. He had undergone T-loop colostomy due to recurrent anal fistula. Colonoscopy and biopsy of colonic mucosa showed Crohn? disease. We report a case of Crohn? disease associated with pyoderma gangrenosum and peripheral arthritis with relevant review of literatures.

The Usefulness of Serum Transferrin Receptor in Anemia with Rheumatoid Arthritis: Comparison with Bone Marrow Iron Store / 대한류마티스학회지

OBJECTIVE: This study was aimed at investigating the usefulness of serum transferrin receptor (sTfR) in anemic patients with rheumatoid arthritis (RA) compared with bone marrow storage iron and other tests for anemia. METHODS: Fifty-five anemic RA patients were undergone anemia study including hematologic indices, iron panel, and sTfR. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured. Eighteen patients performed marrow iron stain. The sTfR and serum ferritin levels were compared with bone marrow iron store, hematologic values, iron batteries, and markers of the disease activity. RESULTS: 1) Mean sTfR concentration was 2.68+/-1.29mg/L in all patients. 2) sTfR correlated significantly with hemoglobin concentration (r=-0.491; p<0.001), hematocrit (r=-0.348; p=0.009), MCV (r=-0.597; p<0.001), RDW (r=0.696; p<0.001), serum iron (r=-0.389; p=0.003), and transferrin saturation (r=-0.451; p=0.001) 3) Ferritin did not correlated significantly with hemoglobin, hematocrit, serum iron/TIBC, MCV and RDW, except reticulocyte count (r=0.295; p=0.032) and total iron binding capacity (TIBC) (r=-0.503; p<0.001). 4) sTfR showed no significant correlation with ESR and CRP, whereas ferritin correlated with CRP (r=0.342; p=0.019). 5) Among the patients who performed iron staining from bone marrow, sTfR was higher in ?ron-depleted? group compared with ?ron replete? group (p=0.040). CONCLUSION: This study suggests that measurement of sTfR may be useful assay for anemia and the possible substitute for invasive bone marrow study in differentiating iron deficiency anemia from anemia of chronic diseases in patients with RA.

1H-Magnetic Resonance Spectroscopy for The Early Diagnosis of Neuropsychiatric Systemic Lupus Erythematosus / 대한류마티스학회지

OBJECTIVE: To investigate the usefulness of 1H-magnetic resonance spectroscopy (1H-MRS) for the early diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE). METHODS: Magnetic resonance image (MRI) and 1H-MRS were performed on fifteen normal volunteers (mean age, 29+/-6 years; age range, 24~40 years) and twenty seven patients with SLE: twelve (26+/-8 years; 16~42 years) with and fifteen (32+/-12 years; 13~57 years) without NPSLE. The localized 1H-MRS was performed by a GE 1.5T SIGNA MRI/MRS system (version 5.5) with active shielded gradients. For all spectra, a Stimulated Echo Acquisition Method (STEAM) localization sequence with three-pulse CHESS H2O suppression was used. The metabolite ratios of N-acetylaspartate (NAA) to creatine (Cr) and choline (Cho) to Cr measured on 1H-MRS of the basal ganglia (BG) and peritrigonal periventricular white matter (PWM). RESULTS: The level of disease activity makers (anti-dsDNA, C3, C4, SLEDAI score), autoantibodies (lupus anticoagulant, anticardiolipin antibody, antiribosomal-P), and EEG did not showed significant difference between the patients without NPSLE and with NPSLE (p>0.05). Thirteen percent (2/15) of patients without NPSLE and fifty percent (6/12) of patient with the NPSLE showed abnormality in MRI. 1H-MRS showed significantly decreased NAA/Cr ratio in BG and increased Cho/Cr ratio in PWM for the patients with NPSLE compared to the patients without NPSLE and normal volunteers (p0.05). But negative correlation was shown between NAA/Cr in BG and Cho/Cr ratio in PWM (r=-0.58, p<0.05). CONCLUSION: NAA/Cr ratio in BG was decreased and Cho/Cr in PWM was increased in NPSLE. The neurometabolite ratio measured by 1H-MRS may be useful in the early detection of NPSLE.

A Case of Crohn? Disease Associated with Pyoderma Gangrenosum and Peripheral Arthritis / 대한류마티스학회지

The Crohn? disease is a inflammatory bowel disease and it? symptoms are nonspecific. The extraintestinal manifestations of Crohn? disease are arthritis, pericholangitis, erythema nodosum, pyoderma gangrenosum, uveitis, episcleritis, and miscellaneous. Arthritic manifestations caused by Crohn? disease belong to seronegative spondyloarthropathies and are divided into peripheral arthritis, spondylitis, and sacroiliitis. And peripheral arthritis in Crohn? disease usually worsen with exacerbation of bowel inflammation but pyoderma gangrenosum, the most severe skin lesion, bears little relationship to the activity or extent of the colitis. A 53 year-old man presented peripheral arthritis on multiple joints and necrotizing ulcerative skin lesion on abdomen and left knee. He had undergone T-loop colostomy due to recurrent anal fistula. Colonoscopy and biopsy of colonic mucosa showed Crohn? disease. We report a case of Crohn? disease associated with pyoderma gangrenosum and peripheral arthritis with relevant review of literatures.

A Case of Acute Respiratory Muscle Failure in Dermatomyositis / 대한류마티스학회지

No abstract available.

A Case of Cardiac Tamponade in a Patient with Rheumatoid Arthritis / 대한류마티스학회지

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by symmetric polyarthritis. RA may cause cardiac diseases by various mechanisms. Pericarditis is the most common cardiac manifestation of RA and has been found in 11~50% of autopsies of patients with RA. However only a few patients have clinical evidence of pericarditis which usually follows a benign course but it may progress to cardiac tamponade or constrictive pericarditis rarely. We experienced a case of cardiac tamponade in a 63-year-old patient with RA whose pericardial fluid analysis suggested rheumatoid pericarditis. He was successfully treated with pericardiocentesis and antirheumatic medication. This is the first case report of cardiac tamponade occurring as a complication of RA in Korea as far as we know.

A Case of Myelofibrosis Associated with Rheumatoid Arthritis / 대한류마티스학회지

Rheumatoid arthritis is thought to be a collagen disease induced by autoimmune mechanism of unknown etiology. Idiopathic myelofibrosis is a myeloproliferative disorder in which the large majority of patients is characterized by anemia, leucoerythroblastosis, splenomegaly, and bone marrow fibrosis with a predominance of megakaryocyte. In some patients autoimmune bone marrow damage has been claimed to be involved in the pathogenesis. A 76-year-old female patient was diagnosed to have rheumatoid arthritis 30 years ago and medicated intermittently. Three months ago, she started to take hydroxychloroquine 300mg/day, prednisolone 7.5mg/day and non-steroidal antiinflammatory drug. One month ago, white blood cell (WBC) count was 5,000/ microliter with the neutrophil count was 3000/ microliter, the hemoglobin (Hb) was 4.3g/dL, the platelet count was 95,000/ microliter and the reticulocyte count was 0.1%. The bone marrow biopsy had revealed hypercellular marrow with increased all hematopoietic element. At this time, the WBC count was 1,600/ microliter and the neutrophil count was 760/ microliter, the Hb was 2.7g/dL, the platelet count was 11,000/ microliter and the reticulocyte count was 0.2%. The bone marrow aspiration resulted in dry tap and the biopsy revealed fibrosis with marked degree of reticulin fibrosis and small numbers of hematopoietic cells.

A Case of Transverse Myelitis as a First Manifestation of Systemic Lupus Erythematosus / 대한류마티스학회지

This is a case report of systemic lupus erythematosus presented as a transverse myelitis. Central nervous system involvement in systemic lupus erythematosus is a relatively common complication. But the transverse myelitis as a central nervous system involvement in systemic lupus erythematosus is rare and the transverse myelitis as the first manifestation of systemic lupus erythematosus has not been reported in Korea. Thus we report a case of the transverse myelitis as a first manifestation of systemic lupus erythematosus with the literature review.

A Case of Pyoderma Gangrenosum Associated with Behcet's Disease / 대한류마티스학회지

Pyoderma gangrenosum may be associated with underlying systemic diseases. The most frequently associated condition is inflammatory bowel disease. Other associations include chronic active and chronic persistent hepatitis, rheumatoid arthritis, leukemia, myeloma, ployarthritis, monoclonal gammopathy, myeloproliferative disorders, systemic lupus erythromatosus ad Behcet's disease. Multiple extensive pyoderma gangrenosum associatie with Behcet's disease has rerely been reported in Korea. Thus, we report a case of multiple pyoderma gangrenosums occurring as pathergy phenomenon at intravenous and intramuscular injection sites in a patient with Behcet's disease.

A case of retroperitoneal fibrosis accompanying immune thrombocytopenic purpura / 대한내과학회지

Retroperitoneal fibrosis is a slowly progressing syndrome that is a part of a systemic fibrosing disease. Most causes are idiopathic, whereas the remainder are associated with methysergide ingestion, malignancy, or aneurysm of abdominal aorta. The pathogenesis is unclear, but the evidences supporting systemic autoimmune process are present, i.e. the apprearance of autoimmune antibodies, especially antinuclear antibody, positive direct or indirect Coombs' test, and the association with immune thrombocytopenia. Effective treatment with corticosteroid is another suggestion of autoimmune nature of this disease. We experienced a case of retroperitoneal fibrosis with immune thrombocytopenic purpura and positive antinuclear antibody. A 44-years old man who was in splenectomy state due to immune thrombocytopenic purpura for 15 years visited us for obstructive uropathy caused by retroperitoneal fibrosis. He was treated with double J catheter insertion in both ureters, and oral medication of corticosteroid and tamoxifen. Renal failure and thrombocytopenia was improved after treatment and the retroperitoneal fibrotic mass size decreased.

A Case of Bilateral Knee Septic Artiritis Complicating Rheumatoid Arthritis / 대한류마티스학회지

Septic artiritis is a disease that causes a rapid joint destruction by various kinds of bacteria such as Staphylococcus aureus. It affects more frequently the patients with rheumatoid arthritis, diabetes, immunocompromised patients, and chronic steroid users. In patients with rheumatoid arthritis, 1 to 12% of patients are affected by septic arthritis. In these patients, it is very difficult to distinguish between an acute exacerbation of rheumatoid arthritis and a development of septic arthritis if the latter affects more than one joint. Septic arthritis usually affects single joint, especially the knee joint. If the diagnosis and treatment are delayed, it would cause sepsis resulting in high mortality and morbidity. Thus early diagnosis by arthrocentesis, prompt drainage, and antibiotics therapy are essential. We experienced a 46 years-old woman with rheumatoid arthritis who abused the steroids for 10 years and complaining recent aggravation of bilateral knee joint swelling, warmth, and tenderness. Large amount of pus from both knees showed Gram positive cocci. The immediate open surgical drainage of both knees was done. The patient recovered from septic arthritis after 6 weeks of antibiotics therapy. The synovial fluid microbiology study should be done in all joints of the patients with the risk factors of joint infection.

A Case of Salmonella Osteomyelitis in a Patient with Systemic Lupus Erythematosus / 대한류마티스학회지

Systemic lupus ertthematosus(SLE) is a prototypic autoimmune disease characterized by the production of antibodies to components of the cell nucleus in association with a diverse array of clinical manifestations. Infection is a major source of morbidity and mortality in parients whth SLE. Although the most frequent etiologic agents are pyogenic organisms such as Staphylococcus species and Echerichia coli, opportunistic pathogens such as uncommon bacteria, fungal organisms, viruses and protozoans have been described. Cases of osteomyelitis due to Salmonella have been reported worldwide, however, it has never been reported in the Korean literature. A 35-year-old female patient with SEL, who has treated with corticosteroid was complicated by osteomyelitis on the life distar femur. A computerized tomography guided aspiration showed greenish yellow pus. Salmonella enteritidis was cultured from the pus. Incision and pus drainage was performed. After 6weeks of antiboitic theraphy, fever, local heat, and swelling improved and she was discharged. We report this patient with a review of relevant literatures.