Japanese
English
- 有料閲覧
- Abstract 文献概要
- 1ページ目 Look Inside
- 参考文献 Reference
要約 目的:ぶどう膜炎に多発性脳神経麻痺を合併した眼・神経サルコイドーシス症例の報告。症例:34歳女性が1か月前からの右眼霧視で受診した。矯正視力は右1.2,左1.5で,右眼に前房内炎症があり,両眼に角膜後面沈着物と隅角結節,網膜静脈周囲炎があった。胸部X線検査で肺門リンパ節の腫脹があり,経気管支肺生検でサルコイドーシスと診断された。初診時から嗅覚と味覚障害があり,1か月後から左三叉神経の不全麻痺と右顔面神経麻痺が生じた。嗅神経,視神経,三叉神経,顔面神経,舌咽神経,迷走神経の多発性脳神経麻痺と診断された。ステロイドパルス療法を行い,3日目から味覚と嗅覚障害が回復し,続いて眼底所見が改善した。10か月後にすべての脳神経障害が寛解し,以後8か月後の現在まで,眼炎症と神経症状の再発はない。結論:ステロイドパルス療法で,サルコイドーシスによる神経と眼病変が改善した。
Abstract. Purpose:To report a case of sarcoidosis with ocular and multiple cranial nerve involvement. Case:A 34-year-old female presented with blurring in the right eye since one month before. She had also anosmia, dysphagia and impaired taste. Findings:Corrected visual acuity was 1.2 right and 1.5 left. The right eye showed signs of anterior uveitis. Both eyes showed peripheral anterior synechia and retinal periphlebitis. X-ray studies showed hypertrophy of pulmonary hilar lymph nodes. Transtracheal biopsy of the lungs led to the diagnosis of sarcoidosis. One month after her initial visit, she developed signs of cranial nerve palsy involving trigeminal, facial, glossopharyngeal and vagal nerves. She was treated by pulsed therapy of methylprednisolone. Anosmia started to improve the third day followed by improved fundus findings. Palsy of cranial nerves recovered 10 months after start of treatment. She has been doing well for 8 months until present. Conclusion:Pulsed corticosteroid therapy was followed by improvement of ocular and nerve findings as manifestation of sarcoidosis.
Copyright © 2014, Igaku-Shoin Ltd. All rights reserved.