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(展示95) 大分県出身の12歳女児の左眼に飛蚊症,眼痛,霧視,充血が生じた。3年前から甲状腺機能亢進症に対してチアマゾール投与を受けていた。左眼に虹彩毛様体炎,硝子体混濁,網膜血管炎,黄斑浮腫があった。螢光眼底造影検査で乳頭の過螢光,網膜血管の透過性亢進,静脈の怒張と蛇行があった。抗HTLV−1抗体が陽性で,甲状腺機能は正常化していた。HTLV−1関連ぶどう膜炎と診断し,プレドニゾロンを投与した。炎症は改善し,左眼視力は当初の0.2が1.2になった。抗HTLV−1抗体が小児ぶどう膜炎と甲状腺機能亢進症に関係しうることを示す例である。
A 12-year-old girl presented with floaters, blurred vision, ocular pain and eye injection in the left eye. She had been receiving systemic thiamazole for hyperthyroidism. The left eye showed signs of iridocyclitis, vitreous opacity, retinal vasculitis and macular edema. Fluorescein angiography showed hyperpermeable retinal vessels. Thyroid function had normalized. She was seropositive for HTLV-1 and was diagnosed as HTLV-1 associated uveitis (HAU). Systemic and topical prednisolone resulted in improvement of visual acuity from the initial 0.2 to 1.2. This case illustrates that anti-HTLV-1 antibody may be causatively related to hyperthyroidism and uveitis in children.
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