双方向の急性痛性プロプトーシス,プトーシス,眼性麻痺,視力の低下を伴うグレヴス病
Lancet (London, England)
|August 25, 1984
まとめ
非典型的甲状腺症の眼疾患は,中年女性の軌道細胞炎を模倣することができます. 早期のCTスキャンと全身ステロイドは,迅速な診断と視力喪失の予防に不可欠です.
科学分野:
- オフタルモロジック (眼科)
- エンドクリノロジー エンドクリノロジー
背景:
- 双方の急性痛性プロプトーシス,プトーシス,眼性麻痺,視力低下は重症症状である.
- 軌道細胞炎は,これらの症状の一般的な初期診断です.
- アチピカル型甲状腺症の眼疾患は,同様の症状を呈しますが,異なる管理が必要です.
研究 の 目的:
- 双方の急性痛性プロプトーシスの症例において,非典型的甲状腺分裂眼疾患を考慮することの重要性を強調する.
- 初期の軌道CTスキャンの診断価値を強調するために.
- この状態における全身性ステロイドの治療効果を強調するために.
主な方法:
- 双方の急性痛性プロプトーシスを持つ2人の中年女性の症例報告.
- 最初の治療は全身性抗生物質で,その後は軌道CTスキャンが行われます.
- 抗生物質をCT検査の結果に基づいて,高用量の全身性ステロイドで代用する.
主要な成果:
- オービタルCTスキャンでは,眼外筋が大きくなり,甲状腺機能障害の症状を示唆していることが明らかになった.
- 患者は抗生物質に反応しなかったが,全身性ステロイドで迅速な改善を示した.
- フォローアップのCTスキャンでは,外眼筋のサイズが減少することが観察されました.
- 一人の患者は甲状腺機能低下症になり,もう一人は甲状腺機能過剰症になりました.
結論:
- 双方向の急性痛性プロプトーシスは,非典型的甲状腺分裂眼疾患を排除するために,早期の軌道CTを正当化します.
- 全身性ステロイドの迅速な投与は,視神経損傷による視覚の喪失を防ぐために不可欠です.
- 急性痛性プロプトーシスの差分診断では,他の典型的な兆候がない場合でも,甲状腺機能障害の眼疾患を考慮する必要があります.
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