両側顔面神経麻痺から完全型Heerfordt症候群を認めた1例

A case of complete Heerfordt syndrome with bilateral facial nerve palsy as the initial manifestation

要約　目的：両眼性顔面神経麻痺で発症し，完全型Heerfordt症候群を呈した1症例の報告。

症例：31歳女性が左側の顔面神経麻痺で受診した。2週前に右側の神経麻痺があり，プレドニゾロンの経口投与で軽快していた。

所見と経過：両眼の前眼部に眼サルコイドーシスの典型的な所見があり，左眼に硝子体混濁と網膜血管炎があった。微熱，耳下腺腫脹，ふどう膜炎があり，完全型のHeerfordt症候群と診断した。

結論：Heerfordt症候群が顔面神経麻痺で初発することがある。

Abstract　Purpose: To report a case of complete Heerfordt syndrome with bilateral facial nerve palsy as the initial manifestation.

Case: A 31-year-old woman was referred to us for left facial nerve palsy. She had developed right facial nerve palsy 2 weeks before that had improved following peroral prednisolone.

Findings and Clinical Course: Both eyes showed typical signs of anterior ocular sarcoidosis. The left eye showed vitreous opacity and retinal vasculitis. She showed mild fever, swelling of parotid glands, and signs of uveitis. These features led to the diagnosis of complete type of Heerfordt syndrome.

Conclusion: The present case illustrates that facial nerve palsy may be the initial manifestation of complete type of Heerfordt syndrome.