Clinically isolated syndromeと診断された小児視神経炎に対し血漿交換を行った1例

A case of childhood optic neuritis diagnosed as clinically isolated syndrome and treated by plasmapheresis

要約　目的：Clinically isolated syndromeと診断された小児視神経炎に対し血漿交換を行った症例報告。症例：左眼視力低下を主訴に受診した12歳女児。所見と経過：視力は右眼（1.2），左眼（0.05）であった。左眼視神経乳頭の発赤・腫脹，MRIで左視神経の造影効果亢進と左大脳脚に脱髄病変を認めた。左眼視神経炎と診断しステロイドパルス療法を施行したが効果不十分と考え血漿交換療法を施行し，視力は左眼（1.5）に改善した。結論：血漿交換療法により速やかな視力改善を得たが，今後多発性硬化症への移行の可能性があり，経過観察が必要と考えられた。

Abstract.　Purpose：To report a case of childhood optic neuritis treated with plasmapheresis. Case：A 12-year-old girl presented with impaired vision in the lefe eye. Findings：Visual acuity was 1.2 right and 0.05 left. The left eye showed hyperemia and swelling of optic disc. MRI showed left optic nerve enhancement with gadolinium and demyelinating lesion in left cerebral peduncle. She was diagnosed with optic neuritis and was treated with pulsed corticosteroid, but the effect was limited. Then, she received plasmapheresis. Her left visual acuity improved to 1.5. Conclusion：Plasmapheresis was effective for childhood optic neuritis. This patient is to be followed up for the risk of multiple sclerosis.