Japanese
English
- 有料閲覧
- Abstract 文献概要
- 1ページ目 Look Inside
要約 57歳男性が1週間前からの右眼視力障害で受診した。矯正視力は右0.01,左0.8であり,眼圧は右40mmHg,左12mmHgであった。右眼には豚脂様の角膜後面沈着物を多数伴う前部ぶどう膜炎があり,左眼にもやや軽症で同様な所見があった。右眼の眼底は透見不能であったが,その他は隅角を含め異常所見はなかった。ツベルクリン反応が陰性で,両側肺門リンパ節腫脹があり,眼サルコイドーシスが疑われた。副腎皮質ステロイド薬の局所と全身投与で軽快し,右眼視力は0.8に回復した。初診から6週間後に通院を中断したが,その6か月後に下痢と腹痛が生じた。内科で免疫性溶血性貧血と特発性血小板減少性紫斑病(Evans症候群)を伴う全身性エリテマトーデス(SLE)と診断された。両眼の前部ぶどう膜炎が再発,悪化し,眼底に軟性白斑と出血斑などSLE網膜症があった。眼病変は副腎皮質ステロイド薬の局所と全身投与で軽快した。本症例の前部ぶどう膜炎の原因として,SLEだけでなくサルコイドーシスの関与が推定された。
Abstract. A 57-year-old male presented with blurring of vision in his right eye since one week before. His corrected visual acuity was 0.01 right and 0.8 left. The intraocular pressure was 40 mmHg right and 12 mmHg left. The right eye showed anterior uveitis with numerous mutton-fat deposits. The left eye showed similar and milder findings. The right fundus was invisible. No other lesions were detected in both eyes. He was negative for tuberculin test. Radiography showed bilateral swelling of hilar lymphnodes. He was tentatively diagnosed with sarcoidosis. Systemic and topical corticosteroid induced improvements in ocular findings 6 weeks later. He developed diarrhea and abdominal pain another 6 months later. He was diagnosed with systemic lupus erythematosus(SLE)associated with Evans syndrome. The anterior uveitis had progressed associated with SLE retinopathy consisting of soft exudates and hemorrhages. It appeared that the anterior uveitis was due to SLE in addition to sarcoidosis.
Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.