眼瞼浮腫を主徴とした伝染性単核症の2例

Palpebral edema as the chief manifestation in two cases of infectious mononucleosis

要約　目的：眼瞼浮腫を主訴として眼科を受診した伝染性単核症の2症例の報告。症例：2例とも19歳女性で，両症例とも両側の上眼瞼浮腫と球結膜充血があった。1例には片眼の球結膜に赤色の隆起性病変があった。眼瞼浮腫と前後して倦怠感と発熱があった。視機能は良好で，眼内に異常所見はなかった。高度の肝機能異常と異型リンパ球の増加があり，伝染性単核症が疑われた。1例ではEpstein-Barr（EB）ウイルス関連抗体の検査で，抗virus capsid antigen（VCA）IgGと抗EB VCA IgMがともに160倍の高値であった。他の1例には抗体検査を行わなかった。眼病変は2症例とも発症から約2週間で寛解した。結論：若年者に両側の眼瞼浮腫があり，発熱と倦怠感を伴うときには伝染性単核症の可能性がある．

Abstract.　Purpose：To report 2 cases of infectious mononucleosis with palpebral edema as the chief manifestation. Cases and Findings：Both were females aged 19 years. Both had edema of upper eyelid and conjunctival hyperemia in both eyes as the chief complaint. One case showed a pink subconjunctival mass in one eye. Both had generalized fatigue and fever since onset of palpebral edema. Both showed normal visual functions and no intraocular abnormalities. They showed laboratory data suggestive of severely impaired liver function. Increased atypical lymphocytes suggested infectious mononucleosis. Anti-viral capsid antigen（VCA）IgG and anti-Epstein-Barr VCA IgM were elevated in one case. The other case received no serological examination. Ocular lesions spontaneously disappeared about 2 weeks after onset in both cases. Conclusion：Bilateral palpebral edema with fever and generalized fatigue in juveniles may be signs of infectious mononucleosis.