Rosai-Dorfman病に合併したぶどう膜炎の1例

Uveitis in a case of Rosai-Dorfman disease

要約　目的：顔面に皮疹がある両眼性ぶどう膜炎患者が，皮膚生検でRosai-Dorfman病と診断された症例の報告。症例：56歳女性が両眼のぶどう膜炎として紹介され受診した。9か月前に嘔気と両眼の充血があり，急性緑内障として手術を受けた。8か月前から顔面に皮疹，6か月前から虹彩炎と硝子体混濁があった。所見：矯正視力は右0.5，左0.05で，両眼に虹彩炎の所見と黄斑浮腫があった。皮膚の生検で組織球増殖があり，Rosai-Dorfman病と診断された。プレドニゾロン内服で眼病変と皮疹は4か月後に寛解し，視力は右0.8，左0.4に改善した。白内障手術で，左右眼とも視力は0.9に回復した。結論：頻度は稀であるが，皮疹を伴う両眼性ぶどう膜炎ではRosai-Dorfman病が関与している可能性がある。

Abstract.　Purpose：To report a case who showed skin eruption and bilateral uveitis and who was later diagnosed with Rosai-Dorfman disease. Case：A 56-year-old female was referred for bilateral uveitis. She had developed nausea and hyperemia in both eyes and had been treated as acute glaucoma 9 months before. She had had skin eruption in the face since 8 months before. Both eyes had shown iritis with vitreous opacity since 6 months before. Findings：Corrected visual acuity was 0.5 right and 0.05 left. Both eyes showed findings of iritis and cystoid macular edema. Skin biopsy showed proliferation of histiocytes and led to the diagnosis of Rosai-Dorfman disease. Systemic prednisolone was followed by improved ocular and skin lesions 4 months later with final visual acuity of 0.9 in either eye. Conclusion：This case illustrates that bilateral uveitis with skin eruption may be manifestations of Rosai-Dorfman disease.