インフリキシマブが奏効したBehçet病の1例

Systemic infliximab was effective in a case of Behçet disease

要約　目的：インフリキシマブの全身投与で寛解したBehçet病1例の報告。症例：55歳男性が2か月前からの霧視で受診した。1年前からアフタが出没し，皮膚病変と陰部潰瘍があった。2か月前からのステロイド薬の内服と点眼は無効であった。所見と経過：矯正視力は右0.3，左0.2で，虹彩炎，硝子体混濁，網膜血管炎が両眼にあり，Behçet病の完全型と診断した。コルヒチンの内服，ステロイド薬の点眼は奏効せず，シクロスポリン内服でもぶどう膜炎発作が頻発した。初診から15か月後にインフリキシマブの投与を始めた。以後3年2か月後の現在，眼発作はなく，アフタ，陰部潰瘍，皮膚発疹も消失した。結論：インフリキシマブの投与でBehçet病の眼発作を抑制できる可能性がある。

Abstract.　Purpose：To report a case of Behçet disease that responded to systemic infliximab. Case：A 55-year-old male presented with blurring in both eyes since 2 months before. He had had repeated episodes of aphthous stomatitis,and had skin lesions and genital ulcer since one year before. Topical and peroral corticosteroid proved futile. Findings and Clinical Course：Corrected visual acuity was 0.3 right and 0.2 left. Both eyes showed iritis,vitreous opacity and retinal vasculitis. He was diagnosed with complete type of Behçet disease. Topical corticosteroid and peroral colchicine failed to prevent further ocular attacks. He started receiving infliximab 15 months after his initial visit. Manifestations of the disease gradually subsided. He is doing well with no ocular attacks,aphthous stomatitis,skin eruptions nor genital ulcer at present after 38 months of treatment. Conclusion：Behçet disease may be brought to remission by administration of infliximab.