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多血管炎性肉芽腫症による無眼球窩痛の症例
Lyvia J Zhang1, Nita Bhat1, Justin Houts1
1Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Orbit (Amsterdam, Netherlands)
|January 7, 2026
まとめ
多血管炎性肉芽腫症(GPA)は、典型的な炎症がない場合でも、無眼球窩痛を引き起こす可能性があります。GPAの迅速な診断と治療により、患者の持続的な眼窩痛が解消され、鑑別診断におけるその重要性が強調されました。
科学分野:
- 眼科学
- リウマチ学
- 全身性血管炎
背景:
- 眼および眼窩の症状は、多血管炎性肉芽腫症(GPA)において一般的である。
- 無眼球窩痛は、消耗性であり、診断が困難な場合がある。
- 以前の眼窩外傷は、眼窩痛の鑑別診断を複雑にする可能性がある。
研究 の 目的:
- 多血管炎性肉芽腫症(GPA)による無眼球窩痛の症例報告。
- 特徴的な徴候がない場合でも、持続的な無眼球窩痛の鑑別診断においてGPAを考慮することの重要性を強調する。
主な方法:
- 両側無眼球症の患者が、難治性の左眼窩痛を呈した症例報告。
- 過去の眼窩骨折のため、当初は眼窩神経痛と診断された。
- 肺炎の診断後、全身的な検査によりGPAと診断された。
主要な成果:
- 患者は、鎮痛剤や経口ステロイドに反応しない左眼窩痛を数週間経験した。
- 画像検査では、眼窩周囲の炎症や眼窩病変は認められなかった。
- GPAの全身治療開始後、眼窩痛は完全に解消した。
結論:
- 多血管炎性肉芽腫症(GPA)は、無眼球窩痛の鑑別診断に含めるべきである。
- 眼窩周囲の炎症や眼窩病変がないことは、眼窩痛の原因としてGPAを除外するものではない。
- GPAの全身治療により、難治性の無眼球窩痛が解消した。
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