1例采用类固醇冲击疗法治疗的巨大结节病脉络膜肉芽肿病例。
A Case of Large Sarcoid Choroidal Granuloma Treated with Steroid Pulse Therapy.
作者信息
Kobayashi Takatoshi, Takai Nanae, Sato Takaki, Tada Rei, Maruyama Eri, Shouda Hiromi, Okamoto Takako, Maruyama Kohichi, Ikeda Tsunehiko
机构信息
Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.
Takai Eye Clinic, Kawachinagano, Japan.
出版信息
Case Rep Ophthalmol. 2020 Mar 11;11(1):112-119. doi: 10.1159/000506437. eCollection 2020 Jan-Apr.
PURPOSE
To report a case of large sarcoid choroidal granuloma that was successfully treated with steroid pulse therapy.
CASE REPORT
A 38-year-old man presented with the primary complaint of decreased visual acuity (VA) in his left eye. Upon examination, a large white protruding lesion of 10 × 8 papilla diameter in size was observed in the macular region, and slightly temporal to it, in the patient's left eye. Whole-body contrast-enhanced computed tomography performed for differential diagnosis detected numerous enlarged lymph nodes throughout the body, including the bilateral hilar regions. Sarcoidosis was diagnosed by biopsy of the right cervical lymph nodes showing noncaseating epithelioid cell granuloma. The fundus lesion was found to be a choroidal granuloma caused by sarcoidosis, and steroid pulse therapy was started. The granuloma was considerably decreased, and the VA in the left eye improved to 0.7 after 2 months.
CONCLUSION
Steroid pulse therapy was found to be effective as an initial treatment for a large sarcoid choroidal granuloma.
目的
报告一例经类固醇脉冲疗法成功治疗的巨大结节病性脉络膜肉芽肿病例。
病例报告
一名38岁男性因左眼视力下降为主诉前来就诊。检查时，在患者左眼黄斑区观察到一个大小为10×8视乳头直径的白色突出大病灶，且稍偏向颞侧。为进行鉴别诊断而进行的全身增强计算机断层扫描发现全身多处淋巴结肿大，包括双侧肺门区域。经右颈淋巴结活检显示非干酪样上皮样细胞肉芽肿，诊断为结节病。眼底病变被发现是由结节病引起的脉络膜肉芽肿，遂开始类固醇脉冲治疗。2个月后，肉芽肿明显缩小，左眼视力提高到0.7。
结论
类固醇脉冲疗法被发现作为巨大结节病性脉络膜肉芽肿的初始治疗有效。
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