黄体・卵胞ホルモン配合剤投与後に失明したBehçet病の1例

A case of loss of vision in a patient with Behçet disease after taking an oral estrogen plus progestin

要約　目的：薬剤投与がBehçet病の大発作を誘発したと考えられる1例を報告する。症例：2004年6月4日に神戸大学病院眼科を初診した51歳女性は，15年来のBehçet病の既往があった。初診時視力は右光覚なし，左矯正0.3であった。経過中に大発作を起こし左眼も光覚なしとなった。発作の2週間前より，婦人科医院にて黄体・卵胞ホルモン配合剤を処方されていた。同配合剤は血栓性静脈炎の既往のある患者には禁忌であった。所見：発作直後は硝子体混濁が強かった。硝子体混濁軽快後，視神経は蒼白で，網膜血管は高度に白鞘化していた。結論： Behçet病患者に対する黄体・卵胞ホルモン配合剤の危険性を周知する必要がある。

Abstract.　Purpose：To report a case of Behçet disease who had severe intraocular inflammation to be blind after taking an oral estrogen plus progestin. Case：A 51 year-old woman who had a 15 year-history of Behçet disease first visited Kobe university hospital June 4, 2004. At the time, the right eye had already had no light perception and the corrected visual aquity was 0.3 in the left eye. About a year after the initial visit, she had a large inflammatory attack in the left eye, and became blind. Two weeks before the sudden visual loss, an oral estrogen plus progestin was prescribed for metrorrhagia by a gynecologist. The drug was contraindicative of patients with thrombophlebitis. Findings：Once the severe vitritis resolved, it was unveiled that the optic nerve was pale and the retinal blood vessels were highly sheathed. Conclusion：The side-effect of the drug should be alerted to ophthalmologists and gynecologists who have opportunities to treat female patients with Behçet disease.