小児に発症したVogt-小柳-原田病の1例

Vogt-Koyanagi-Harada disease in a child

要約　目的：小児に発症したVogt-小柳-原田病（原田病）の1症例の報告。

症例：12歳の女児が右眼視力低下，霧視を主訴に受診した。

所見：矯正視力は右0.15，左0.7であった。両眼前房に炎症細胞，右眼底に漿液性網膜剝離があった。メチルプレドニゾロン500mg/日の点滴投与3日間，プレドニゾロン40mg/日から内服漸減し，治療12日後には炎症および漿液性網膜剝離はほぼ消退し，右眼矯正視力は0.7に改善した。副作用はなく，炎症の再燃はなかった。

結論：小児の原田病に対し，ステロイド薬のミニパルス療法が有効であった。

Abstract　Purpose：To report a 12-year-old girl who developed Vogt-Koyanagi-Harada disease.

Case：A 12-year-old gird presented with blurring and impaired vision in her right eye as chief complaint.

Findings and Clinical Course：Corrected visual acuity was 0.15 in the right eye and 0.7 in the left. Both eyes showed signs of inflammation in the anterior chamber. The right eye showed serous retinal detachment. She was found to have hypacusia. The findings led to the diagnosis of Vogt-Koyanagi-Harada disease. She was treated by intravenous methylprednisolone at the daily dosis of 500 mg for 3 days followed by peroral prednisolone at the decreasing dosis of 40 mg per day. Signs of inflammation and serous retinal detachment almost disappeared 12 days later. The right visual acuity improved to 0.7. There has been no side effect or recurrence of inflammation for 11 months until present.

Conclusion：Systemic treatment with corticosteroid was followed by prompt recovery of Vogt-Koyanagi-Harada disease in a 12-year-old child.