クローン病にみられた蚕食性角膜潰瘍の1例

A case of rodent ulcer associated with Crohn's disease

　我々は最近，大腸クローン病に蚕食性角膜潰瘍の合併した症例を経験した．この両者の合併例の報告は今までには認められない．

　症例は39歳女性で，頻回の粘液血性の下痢，腹痛などの臨床所見と，内視鏡，注腸造影および生検の結果から，大腸クローン病と診断された．一方，腸病変の悪化と同時に，右眼の疼痛，充血を自覚し，角膜鼻側辺縁部に急峻な侵蝕像を伴った深い潰瘍を認め，Mooren's ulcerと診断した．プレドニゾロンとサラゾスルファピリジンによる全身療法および，4％グルタチオン点眼を行った．腸および眼病変は，ほぼ同じ頃に改善した．これら両病変の発症機構について，免疫学的立場から検討しな．

A 39-year-old female had been suffering with persistent diarrhea for about a year. Pain and hyperemia in the right eye developed after an episode of exacerbation of bowel symptoms. The diagnosis of Crohn's disease affecting the colon was made on the basis of radiological findings, sigmoidoscopy and biopsy. Ophthalmologically, corneal ulcer with overhanging infiltrated edge was detected leading to the diagnosis of rodent ulcer (Mooren).

The patient was treated with systemic cortico-steroid and thiazosulfapyridine and with topical glutathione. The ocular and bowel symptoms improved in about a month. While this case appears to be the first reported one of rodent ulcer associated with Crohn's dis-ease, it is our impression that the ocular and intestinal affections were based on similar im-munological disturbances.