インターフェロン投与中に発症した原田病の1例

Harada disease in a case during interferon therapy for chronic hepatitis C

要約　目的：インターフェロンによる治療中に原田病が発症した症例の報告。症例：66歳女性に右眼の視力低下と変視症が2週前に生じた。1年前にC型慢性肝炎を指摘され，10週前からインターフェロンの経口投与を受けていた。所見：矯正視力は右0.05，左0.5で，両眼に虹彩炎の所見と眼底後極部の滲出性網膜剝離があった。蛍光眼底造影で点状の色素漏出と網膜剝離下に色素貯留があり，原田病と診断した。インターフェロンを中止し，副腎皮質ステロイドのパルス療法を行った。網膜剝離は速やかに消失し，10か月後には両眼に夕焼け状眼底が生じた。結論：インターフェロンの経口投与が原田病を誘発した可能性がある。

Abstract.　Purpose：To report a case who developed Harada disease during peroral interferon therapy for chronic hepatitis C. Case：A 66-year-old female presented with impaired visual acuity and metamorphopsia in her right eye since 2 weeks before. She had been diagnosed with chronic hepatitis C one year before. She had been receiving peroral interferon since 10 weeks before. Findings：Corrected visual acuity was 0.05 right and 0.5 left. Both eyes showed signs of iritis and exudative retinal detachment in the posterior fundus. Fluorescein angiography showed multiple dye leakage and pooling of fluorescein in the subretinal space. These findings led to the diagnosis of Harada disease. Discontinuation of interferon with pulsed corticosteroid therapy was followed by disappearance of retinal detachment. Sunset-glow fundus appeared in both eyes 10 months later. Conclusion：This case illustrates that systemic interferon therapy may induce Harada disease as an unusual complication.