Open Access, Peer-reviewed
pISSN 2288-0402
eISSN 2288-0410
    Allergy Asthma Respir Dis. 2013 Mar;1(1):94-97. Korean.
    Published online Mar 31, 2013.
    https://doi.org/10.4168/aard.2013.1.1.94
    © 2013 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology
    Case Report

    A case of fat embolism syndrome in juvenile rheumatoid arthritis patient

    Kyung Hoon Kim,1 Ju Kyung Lee,1 Young Hun Choi,2 Woo Sun Kim,2 June Dong Park,1 Young Yull Koh,1 and Dong In Suh1
      • 1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
      • 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
    • Correspondence to: Dong In Suh. Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-4192, Fax: +82-2-2072-3917, Email: dongins0@snu.ac.kr
    Received October 22, 2012; Revised December 27, 2012; Accepted December 27, 2012.

    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/).

    Abstract

    Fat embolism syndrome is a serious complication that can occur after trauma or operation of the limbs. Clinical criteria are used for the diagnosis of fat embolism syndrome and sometimes radiologic findings are helpful. Fat embolism syndrome is known to occur less frequently in children than in adults, but there is an increased risk in children with connective tissue disease. However, there are only a few reported cases of fat embolism syndrome in juvenile rheumatoid arthritis which is the most common connective tissue disease in children. We report a case of fat embolism syndrome diagnosed in a 13-year-old boy with juvenile rheumatoid arthritis, which was treated with corticosteroid.

    Keywords
    Fat embolism; Juvenile rheumatoid arthritis

    Figures

    Fig. 1
    Initial chest computed tomographic scan shows ground-glass opacities at the left lower lobe (arrows).

    Fig. 2
    (A) Chest radiograph obtained 2 days after admission revealed bilateral diffuse haziness. (B) Follow-up chest computed tomographic scans obtained on the same day demonstrate multiple small nodules (arrows) and diffuse ground-glass opacities in both lungs.

    Fig. 3
    Fundus exam shows multiple white patches in the right fundus with an embolic infarct at the macula.

    Fig. 4
    Ten days later, nodular and ground-glass opacities on chest computed tomography were completely resolved.

    Tables

    Table 1
    Gurd's diagnostic criteria of fat embolism

    Table 2
    Fat embolism index

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    MeSH Terms
    Adult
    Arthritis, Juvenile Rheumatoid
    Child
    Connective Tissue Diseases
    Embolism, Fat
    Extremities
    Humans
    Metrics
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    Tables
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