Hashida Noriyasu, Kanayama Shintaro, Kawasaki Atsushi, Ogawa Kenji
Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.
Jpn J Ophthalmol. 2005 May-Jun;49(3):253-6. doi: 10.1007/s10384-004-0177-5.
Vogt-Koyanagi-Harada disease (VKH), an inflammatory ocular disorder characterized by bilateral granulomatous panuveitis and a variety of extraocular manifestations, has been reported to be associated with various immune disorders but has not been linked to malignant lymphoma (ML).
We present here a case of VKH associated with a recurrence of ML.
A 69-year-old man who initially had ML presented with a history of sudden bilateral visual acuity loss. Funduscopy showed papilloedema and serous retinal detachment in both eyes, and a diagnosis of VKH was reached soon thereafter. Chest X-ray and an abdominal computed tomography scan indicated the metastatic focus of the ML. A recurrence was suspected because the ML-associated soluble interleukin-2 receptor (sIL-2R) in the serum was highly elevated. Treatment successfully resolved both the ML and the VKH. The inflammatory activities of VKH and ML were found to correlate with the serum levels of sIL-2R.
This case suggests an association between sIL-2R levels and disease activity in VKH and ML, and provides additional evidence that VKH can be induced by immune disorders caused by high sIL-2R levels in ML.
伏格特-小柳-原田病（VKH）是一种以双侧肉芽肿性全葡萄膜炎和多种眼外表现为特征的炎症性眼病，据报道与多种免疫疾病有关，但尚未与恶性淋巴瘤（ML）相关联。
我们在此报告一例与ML复发相关的VKH病例。
一名最初患有ML的69岁男性出现双侧视力突然丧失的病史。眼底检查显示双眼视乳头水肿和浆液性视网膜脱离，此后不久确诊为VKH。胸部X线和腹部计算机断层扫描显示了ML的转移灶。由于血清中与ML相关的可溶性白细胞介素-2受体（sIL-2R）高度升高，怀疑有复发。治疗成功地解决了ML和VKH。发现VKH和ML的炎症活动与血清sIL-2R水平相关。
该病例提示sIL-2R水平与VKH和ML的疾病活动之间存在关联，并提供了额外的证据表明VKH可由ML中高sIL-2R水平引起的免疫紊乱诱发。
