Familiäre Akroosteolyseについて

FAMILIARY ACROOSTEOLYSIS

Ⅰ．はしがき

　足穿孔症の中には家族的にあらわれる骨変化が原因になつているものがある。1950年にHarna-sch^1）がDie Akroosteolyse, ein neues Krank-heitsbildと発表して以来，1つの独立疾患と認めるもの，あるいは1つの症状に過ぎないとするものとの争論が絶えないのであるが，最近吾々はこの記載に一致すると思われる症例を経験したので報告する。

A 22-year-old housewife has suffered from chronic repreated ulcers on the first toe of the right foot since 17 years of age. During that time the patient was under the care of a speci-alist for leprosy, who failed to prove Mycobacterium leprae and thickning of the peripheral nerves and did not make the diagnosis of leprosy.

Her past history was not contributory. In family history the paternal great-grandfather was said to have the same skin lesion and her parents were consanguinous.

At the first visit, coin-sized ulcers were noted on the sole and root of the first toe and severe of all the toes of the right foot.

Although the results of the routine laboratory tests remained within normal limits, roentge-nograms of the bones were characteristic. They were as followes: 1) irregular periostal thickening of the tibial and fibular bones, 2) osteolysis and deformity of the ends of the first metatarsal bones, 3) osteolysis of the ends of the second to fifth metatarsal bones, 4) severe deformity of the joints of the first toes, 5) osteoporosis of the fourth and fifth lumbar and the first sacral spines, and 6) slight enlargement of the intervertebral spaces.

She complained of slight hypesthesia and hypalgesia on the fourth and fifth lumbar and the first sacral segments of the both lower legs while the disturbance of motion of the toes was not noted.