インフリキシマブの早期導入で良好な経過を示しているBehçet病ぶどう膜炎の症例

Remission of uveitis in Behçet disease after early treatment with infliximab

要約　目的：Behçet病患者のぶどう膜炎に対しインフリキシマブの早期投与をした症例の報告。症例と方法：Behçet病ぶどう膜炎がある3症例にインフリキシマブの全身投与を行った。29歳男性，28歳女性，27歳男性である。インフリキシマブ投与は，1例は前房蓄膿の初回発作から5日目，1例は7か月前からの陰部潰瘍と口内炎のあとに生じた片眼性前房蓄膿の初回発作の翌日，1例は6年前から口腔アフタと両眼のぶどう膜炎が続いたのちに開始した。結果：早期投与を行った2例では眼発作の再発がそれぞれ9か月間と8か月間はなく，視力と全身状態が改善した。病変が長期間続いていた1例では，眼発作が再発し視力は変化しなかった。3症例ともインフリキシマブ投与による重篤な副作用はなかった。結論：Behçet病でぶどう膜炎が悪化する前のインフリキシマブ投与は，少数例を短期観察した限り，安全かつ有効であった。視機能維持のために早期導入が望まれる可能性がある。

Abstract.　Purpose：To report cases of Behçet disease who showed remission of uveitis after early treatment with infliximab. Case：This retrospective study was made on 3 cases of Behçet disease, comprising 28-year-old female and 2 males aged 27 and 29 years respectively. Treatment with systemic infliximab was started 5 days after first attack of hypopyon uveitis in one case, immediately after the first attack of hypopyon uveitis following 7 months of genital ulcer and aphthous stomatitis in another, and 6 years after uveitis and systemic manifestations in the third. Results：In 2 cases who received infliximab soon after ocular attack, there has been no episode of uveitis during 8 and 9 months respectively. The third case, who was treated after the disease had persisted, showed ocular attacks with no improvement in visual acuity. Conclusion：Systemic infliximab was safe and effective for uveitis in Behçet disease in the small number of patients followed up for a limited period. The findings seem to suggest that this therapeutic modality is to be introduced in the early stage of the disease.