Japanese
English
- 有料閲覧
- Abstract 文献概要
- 1ページ目 Look Inside
- 参考文献 Reference
要約 目的:視神経炎を呈した抗myelin oligodendrocyte glycoprotein(MOG)抗体関連疾患の小児2例の報告。
症例1:13歳,女児。左眼の視力低下を主訴に近医を受診し,左視神経乳頭浮腫のため総合病院に紹介となった。MRIで左視神経の腫大を認め,視神経炎を疑われ当科を受診した。初診時の矯正視力は右1.0,左0.01,左視神経乳頭の発赤・浮腫を認めた。視神経炎と診断し,初診日よりステロイドパルス療法を開始した。1クール終了時に左眼矯正視力は1.2まで回復した。
症例2:7歳,女児。右眼視野欠損,発熱を主訴に近医眼科を受診し,両視神経乳頭浮腫のため近医脳外科に紹介となった。髄液細胞数の増加のため髄膜炎を疑われ,総合病院小児科でのMRIで両側の視神経の腫大を認め,当院小児科へ転院となった。初診時の視力は右光覚弁,左1.0で,著明な右眼視野狭窄と,右優位な視神経乳頭の発赤・浮腫を認めた。視神経炎と診断し,ステロイドパルス療法を3クール施行し,初診から64日後には右眼矯正視力1.0まで回復した。
所見:2症例ともステロイド治療が著効した。治療前血清・髄液より抗MOG抗体陽性が判明した。
結論:小児の抗MOG抗体陽性視神経炎2例を経験し,ステロイド治療が著効した。
Abstract Purpose:To report two pediatric cases of anti-myelin oligodendrocyte glycoprotein(MOG)antibody related diseases.
Case 1:A 13-year-old girl presented with blurred vision in her left eye. Magnetic resonance imaging(MRI)showed a swollen left optic nerve. The corrected visual acuity was 1.0 in the right and 0.01 in the left. Corticosteroid pulse therapy was initiated. Visual acuity in the left recovered to 1.2 after the first course of corticosteroid pulse therapy.
Case 2:A 7-year-old girl presented with fever and visual field defect in her right eye. Meningitis was suspected due to pleocytosis. Both optic nerves were swollen on MRI. Corrected visual acuity was light perception in the right eye and 1.0 in the left. The right eye showed marked swelling of the optic disc and severe visual field constriction. She received 3 courses of corticosteroid pulse therapy. Visual acuity in the right eye recovered to 1.0 two months after the diagnosis.
Findings and Clinical Course:Corticosteroid pulse therapy was effective and anti-MOG antibody was detected in the serum and spinal fluids obtained before the treatment in both cases.
Conclusion:Corticosteroid pulse therapy was effective in two pediatric cases of anti-MOG antibody-positive optic neuritis.
Copyright © 2021, Igaku-Shoin Ltd. All rights reserved.