AIDSの初発病変であったサイトメガロウイルス網膜炎の1例

A case of cytomegalovirus retinitis as the primary clinical symptom in a patient with acquired immunodeficiency syndrome

　血友病Aで血液製剤を投与され，HIV （human immunodeficiency virus）抗体陽性となり，細胞性免疫能不全でサイトメガロウイルス網膜炎が発症し，臨床的にAIDS （acquired immunodeficiency syn—drome）と診断された1例を経験した。ガンシクロビル，抗サイトメガロウイルスヒトモノクローナル抗体の点滴で網膜病変は消退したが，ガンシクロビルの減量で網膜炎が2度再燃した。ガンシクロビル硝子体内注入を行い，網膜病変は鎮静化したが，ガンシクロビルの点滴中止4週間後に再燃した。

A 22-year old male presented with blurred vision in his right eye. He had suffered from hemophilia A at age 4 and was positive for human immunodeficiency virus at age 15. Both eyes manifestedretinal hemorrhage and exudates with sheathing of the retinal vessels. Antigenemia for cytomegalovirus was demonstrated after the retinitis. Intravenous administration of gancyclovir and anti-cytomegalovirus human monoclonal antibody arrested the progression of the retinitis, but reduction of the gancyclovir twice causedreactivation of the retinitis. Gancyclovir was then given by intravitreal injections and intravenous adminis-tration was stopped. This arrested the progression of the retinitis for four weeks.