眼瞼下垂で発症した眼瞼・結膜限局性アミロイドーシスの1例

Blepharoptosis as the initial manifestation in a case of localized eyelid and conjunctival amyloidosis

　79歳女性が眼瞼下垂を主訴として受診した。10数年前から上眼瞼腫脹と眼瞼下垂が右眼にあった。両眼に眼瞼下垂があり，瞼裂の上下幅は左右とも2mmで，眼瞼皮膚が固く，開瞼維持が困難であった。球結膜は可動性に乏しく，固い腫瘤性変化があった。単純CTで，眼部軟組織の肥厚と，涙腺部と上眼瞼に石灰化があり，アミロイドーシスが疑われた。生検で球結膜にアミロイド沈着があったが，全身的には他臓器障害は否定され，眼瞼と球結膜に限局する原発性アミロイドーシスと診断した。

A 78-year-old female visited us for blepharoptosis. She had had swelling of upper eyelid and blepharoptosis in her right eye for over 10 years. Both eyes showed blepharoptosis. The vertical lid opening was 2mm in either eye. The eyelids had become stiff. The bulbar cojunctiva was thickened and inelastic. Simple computerized tomography（CT）showed hypertrophic soft tissue around the eye and calcification in the lacrimal glands and upper eyelids. These findings were suggestive of amyloidosis. Biopsy of bulbar conjunctiva showed deposit of amyloid. Involvement of systemic organs could be ruled out. She was diagnosed with primary localized eyelid and conjunctival amyloidosis.