Crohn病に合併したHLA-B27陽性急性前部ぶどう膜炎の1例

A case of Crohn disease with HLA-B27 positive acute anterior uveitis

　目的：Crohn病に併発したHLA-B27陽性急性前部ぶどう膜炎の1症例の報告。症例：26歳男性。18歳時に全大腸炎型のCrohn病と診断され，22歳時から左眼ぶどう膜炎として加療されていた。所見と経過：右眼の充血と眼痛で受診し，右眼瞳孔領にフィブリン膜形成を伴う虹彩炎があり，急性前部ぶどう膜炎と診断した。副腎皮質ステロイド薬点眼に反応し視機能が改善した。ヒト白血球抗原検査でHLA-B27陽性であった。強直性脊椎炎などの腸管外合併症はなかった。以後現在までの1年間，ぶどう膜炎の再発はない。結論：急性前部ぶどう膜炎では基礎疾患の把握とHLA検査が診断と経過観察において重要である。

　Purpose：To report a case of Crohn disease with HLA-B27 positive acute anterior uveitis. Design：Observational case report. Case：A 26-year-old man presented with hyperemia and pain in his right eye. He had been diagnosed with Crohn disease at the age of 18 years. He had been under treatment for uveitis in his left eye since the age of 22 years. Findings：His right eye showed fibrin membrane and inflammatory cells,leading the diagnosis of acute anterior uveitis. The condition responded well to topical corticosteroid. He was found positive for HLA-B27 antigen. He had no other systemic complications including ankylosing spondylitis. He has been doing well during one year until present. Conclusion：Systemic examinations and HLA typing are essential in the diagnosis and management of acute anterior uveitis.