9歳児に発症したVogt-小柳-原田病の1例

Vogt-Koyanagi-Harada disease in a 9-year-old girl

要約　目的：9歳女児に発症したVogt-小柳-原田病（以下，原田病）の1例報告。

症例：9歳女児が両眼の歪視および視力低下を主訴に紹介され受診した。

所見：矯正視力は右0.2，左0.1で，両眼底に多房性の漿液性網膜剝離，髄液検査で単核球優位の細胞増多がみられた。メチルプレドニゾロン16.7mg/kg/日の点滴投与3日間およびその後のプレドニゾロン内服漸減で速やかに症状が軽快し，治療開始から9か月後の現在まで再発はない。

結論：小児の原田病に対し，発症早期の副腎皮質ステロイド薬の大量全身投与が有効であった。

Abstract　Purpose: To report a nine-year-old girl who developed Vogt-Koyanagi-Harada（VKH）disease.

Case: A 9-year-old girl was referred to us with metamorphopsia and impaired vision in both eyes as the chief complaint.

Findings: Corrected visual acuity was 0.2 right and 0.1 left. Both eyes showed multiple areas of serous retinal detachment. The cerebrospinal fluid showed pleocytosis mainly consisting of monocytes. She was treated by intravenous methylprednisolone at the daily dosis of 16.7 mg/kg for 3 days followed by tapering dosis of peroral prednisolone 1 mg/kg per day. Clinical findings rapidly improved with no recurrence for 9 months until present.

Conclusion: High systemic dosis of corticosteroids was effective for VKH disease in a child.