両側耳下腺・涙腺腫脹で発症したサルコイドーシスの1例

Sarcoidosis presenting as bilateral swelling of the parotid and lacrimal glands. A case report

Ⅰ　はじめに

　サルコイドーシスは原因不明の類上皮細胞肉芽腫性疾患であり，全身の多臓器に出現する。ぶどう膜炎，耳下腺腫脹，顔面神経麻痺の3徴候に微熱を伴うHeerfordt症候群はサルコイドーシスの一亜型として知られている。今回われわれは，両側耳下腺・涙腺の腫脹（いわゆるミクリッツ徴候）で発症し，ぶどう膜炎と顔面神経麻痺を伴ったサルコイドーシスの1例を経験したので報告する。

　A 35-year-old man presented with bilateral parotid swelling. CT scanning revealed bilateral swelling of the parotid and lacrimal glands and bilateral hilar lymphadenopathy. Serum angiotensin-coverting enzyme（ACE）and lysozyme activities were elevated. Histological examination of the parotid gland biopsy specimen revealed noncaseating epithelioid cell glanulomas,compatible with sarcoidosis. The swelling of the parotid and lacrimal glands improved without medication,but right facial nerve palsy developed one month after the biopsy with more elevation of serum ACE and lysozyme activities. Administration of prednisolone improved the facial nerve palsy and the serum ACE and lysozyme activities.