尋常性乾癬に合併したBehçet病ぶどう膜炎に対してインフリキシマブを投与した1例

A case of Behçet disease and psoriasis treated by systemic infliximab

要約　目的：尋常性乾癬があるBehçet病の1症例にインフリキシマブの投与を行った報告。症例：34歳男性が3年前からの霧視で受診した。12年前に尋常性乾癬と診断され，シクロスポリン内服などの治療を受けていた。過去3年間に複数回のぶどう膜炎の発作があった。所見：両眼の硝子体混濁，網膜滲出斑を伴う網膜血管炎と口腔内アフタがあり，Behçet病と診断した。シクロスポリン内服を継続したが，ぶどう膜炎の発作が頻発し，初診の22か月後からインフリキシマブの投与を開始した。尋常性乾癬とぶどう膜炎は改善したが，6か月後から軽度の再燃が起こった。結論：インフリキシマブの全身投与は，尋常性乾癬とBehçet病のぶどう膜炎に奏効し，症状が軽快した。

Abstract.　Purpose：To report the outcome of treatment with infliximab in a case of Behçet disease overlapped with psoriasis. Case：A 34-year-old male presented with blurring in both eyes since 3 years before. He had been diagnosed with psoriasis 12 years before and been treated with peroral cyclosporine. He had had repeated attacks of uveitis in the past 3 years. Findings：Both eyes showed vitreous opacity and retinal vasculitis with retinal exudates. Oral aphtha was also present. The findings led to the diagnosis of Behçet disease. Attacks of uveitis continued after continued treatment with cyclosporine. He started receiving infliximab 22 months after his initial visit. The treatment was followed by remission of psoriasis and attacks of uveitis. Moderate recurrence occurred 6 months later. Conclusion：Infliximab was effective for psoriasis and uveitis in this patient.