難治性ぶどう膜炎に対する血漿交換療法について

Plasma exchange therapy for intractable uveitis

　Plasma cxchangeは自己免疫が関与する疾患に対し最近試みられている治療法である．目的は病的因子となる高分子物質の除去であり，我々はdouble filtration systemを難治性ぶどう膜炎に使用した．

　症例1は48歳男性で，ベーチェット病で罹病期間は12年間で，59年より再発を数回おこし，視力が低下した例である．症例2は69歳男性，5年前より完全に治癒しない原因不明のendogenous chronic uveitisでステロイド全身投与が中止にできない症例である．両者に対し，週1回計3回，6,000〜7,000mlの血漿交換を行い，明らかに血液成分を改善させ，症例2においては，臨床症状の自覚的，他覚的な改善が得られ，ステロイドの全身投与が中止できるようになった．

Plasma exchange therapy for autoimmune diseases aims at removal of high-molecular substances asso-ciated with the pathogenesis or aggravation of the disease. We treated two patients with recalcitrant chronic uveitis by this means using double filfration system.

One was a 4R-year-old male with Behçet's disease of 12 year's duration. The ocular manifestations became aggravated during the past one year dueto bilateral involvement of the fundus. The second case was a 69-year-old male with persistent uveitis of unknown nature for 5 years. He had to be placed under continuing systemic corticosteroid therapy.

Both cases were treated by plasma exchange the-rapy totaling 6,000 to 7,000ml divided in three sessions. The initially abnormal laboratory data of the circulating blood showed improvements in both cases. While the clinical features in the first case remained unchanged, we could discontinue systemic corticosteroid therapy in the second case due to improvements in clinical features.