トリアムシノロンアセトニド局所注射が著効した甲状腺眼症による上眼瞼腫脹の1例

Local injection of triamcinolone acetonide was effective for palpebral edema in a case of thyroid ophthalmopathy

要約　目的：甲状腺眼症による眼瞼腫脹にトリアムシノロンアセトニドの局所注射が奏効した症例の報告。症例：54歳女性が3か月前からの右眼上眼瞼腫脹で受診した。所見：右眼の上眼瞼腫脹とGraefe徴候があり，眼球突出度は左右眼とも10mmであった。抗甲状腺ホルモンレセプタ抗体値の上昇があり，甲状腺眼症と診断した。トリアムシノロンアセトニド40mgを上眼瞼円蓋部結膜下に注射した。1週間後から眼瞼腫脹は軽減しはじめ，2か月後には前頭眼瞼溝が明瞭化し，投与から7か月後の現在まで再発はない。結論：甲状腺眼症による眼瞼腫脹にトリアムシノロンアセトニドの局所注射が奏効した。

Abstract.　Purpose：To report a case of thyroid ophthalmopathy with palpebral edema that disappeared after local injection of triamcinolone acetonide. Case：A 54-year-old female presented with edema of the right upper eyelid since 3 months. Findings：Her right eye showed edema of the upper eyelid and positive sign of Graefe. Both eyes showed proptosis by 10 mm. She showed elevated serum level of thyrotropin receptor antibody,leading to the diagnosis of thyroid ophthalmopathy. She received subconjunctival injection of 40 mg triamcinolone acetonide in the upper fornix. Eyelid edema started to regress one week later. Palpebral sulcus became manifest after 2 months of injection. There has been no recurrence during 7 months until present. Conclusion：Local injection of triamcinolone acetonide was effective for palpebral edema as manifestation of thyroid ophthalmopathy.