トリアムシノロンテノン囊下注射が奏効した間質性腎炎ぶどう膜炎症候群の小児例

Subtenon injection of triamcinolone was effective for tubulointerstitial nephritis and uveitis syndrome in a child

要約　目的：トリアムシノロンテノン囊下注射（STTA）が奏効した間質性腎炎ぶどう膜炎症候群の小児例の報告。

症例：15歳女児が7日前からの左眼の結膜充血，眼痛，霧視で受診した。

所見と経過：矯正視力は左右とも1.2で，両眼の角膜後面沈着物，虹彩結節，前房に細胞の浮遊，視神経乳頭の発赤腫脹があった。初診7日目に近医から腎障害があるとの連絡を受け，精査の結果，間質性腎炎ぶどう膜炎症候群と診断した。ベタメタゾン点眼でぶどう膜炎が軽快しないので，初診8日目にSTTAを行い，2週後にほぼ寛解した。ぶどう膜炎が3か月後に再燃し，STTAで消炎した。

結論：間質性腎炎ぶどう膜炎症候群での眼病変にSTTAが奏効したが，再燃があった。

Abstract　Purpose：To report a case of tubulointerstitial nephritis and uveitis（TINU）syndrome successfully treated by subtenon injection of triamcinolone acetonide.

Cases：A 15-year-old girl presented with conjunctival hyperemia, pain and blurring in the left eye since one week before.

Findings and Clinical Course：Corrected visual acuity was 1.2 right and 1.2 left. Both eyes showed keratic precipitates, cells in the anterior chamber, iris nodules, and swelling of optic disc. She was suspected of renal failure, and was diagnosed with TINU 7 days later. Both eyes received subtenon injection of triamcinolone acetonide after topical treatment with betamethasone proved futile. Ocular manifestations of TINU resolved 2 weeks later. Uveitis recurred 3 months later and resolved after subtenon injection of triamcinolone acetonide.

Conclusion：Subtenon injection of triamcinolone acetonide was effective for ocular manifestations of TINU syndrome. The same treatment was effective for recurrence 3 months later.