結膜炎と結膜潰瘍を認めたBehçet病疑いの1例

Conjunctivitis and conjunctival ulcer in a case suspected of Behçet disease

要約　目的：結膜炎と結膜潰瘍があり，全身所見からBehçet病が疑われた症例の報告。症例：44歳女性が2年前からある両眼の眼瞼腫瘤と左眼の眼痛で受診した。両眼の上眼瞼に出血しやすい巨大乳頭結膜炎と，左眼の球結膜に潰瘍があった。以前から腰痛と微熱があり，整形外科で両側仙腸関節炎と診断された。皮膚科では口腔内アフタと毛囊炎様の皮疹が頸部と前胸部にあり，Behçet病の疑いと診断された。球結膜の生検で，結膜上皮内と間質の血管周囲に炎症細胞の浸潤があった。眼症状は副腎皮質ステロイドの局所投与で軽快した。結論：結膜炎と結膜潰瘍はBehçet病の眼症状である可能性がある。

Abstract.　Purpose：To report a case with conjunctivitis and conjunctival ulcer suspected of Behçet disease. Case and Findings：A 44-year-old female presented with pain in her left eye and tumor in both eyelids since 2 years before. She showed conjunctival ulcer in the left eye and giant papillary conjunctivitis in both eyes. She had fever and lumbago and was diagnosed with bilateral sacroiliac arthritis. She had oral aphtha and folliculitis in the neck and breast, which a dermatologist diagnosed with suspected Behçet disease. Biopsy of bulbar conjunctiva showed perivascular infiltration of inflammatory cells. Ocular symptoms subsided after topical corticosteroid. Conclusion：Conjunctivitis and conjunctival ulcer may be manifestations of Behçet disease.