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[一例与肉芽肿性全葡萄膜炎相关的多发性硬化症]

[A case of multiple sclerosis associated with granulomatous panuveitis].

作者信息

Moriwaka F, Tashiro K, Fukazawa T, Miyagishi R, Sasamoto Y

机构信息

Department of Neurology, Hokkaido University School of Medicine.

出版信息

Rinsho Shinkeigaku. 1994 Jul;34(7):727-9.

PMID:7955734
Abstract

A case of multiple sclerosis (MS) associated with granulomatous panuveitis was reported. A 45-year-old woman developed diplopia in 1972, at age 24, optic neuritis in 1974 and acute transverse myelopathy in 1981. Subsequently, while being under our care with the clinical diagnosis of MS, right abducens palsy in 1989, deterioration of paraparesis with remission in 1991, and weakness of left arm in 1992 occurred. CSF study revealed high IgG index and brain MRI showed multiple abnormal intensity areas in the deep white matter and periventricular areas bilaterally. On the beginning in March, 1993, she noticed left hazy vision and the ophthalmological examinations revealed marked mutton-fat like keratic precipitates, posterior synechiae, cells and flare in anterior chamber, retinal phlebitis and snow ball vitreous opacity. Granulomatous panuveitis was diagnosed and treated by topical steroid with improvement within two months. During this episode, no neurological deterioration was seen. Granulomatous uveitis in MS was rarely documented in the literatures, but this seems to be more common in women, mildly symptomatic or asymptomatic and responds well to topical steroid treatment.

摘要

报告了一例与肉芽肿性全葡萄膜炎相关的多发性硬化症(MS)病例。一名45岁女性在1972年24岁时出现复视,1974年出现视神经炎,1981年出现急性横贯性脊髓病。随后,在我们对其进行MS临床诊断的治疗过程中,1989年出现右侧外展神经麻痹,1991年截瘫加重并缓解,1992年出现左臂无力。脑脊液检查显示IgG指数升高,脑部MRI显示双侧深部白质和脑室周围区域有多个异常强化区域。1993年3月开始,她发现左眼视力模糊,眼科检查发现有明显的羊脂状角膜后沉着物、虹膜后粘连、前房细胞和闪光、视网膜静脉炎以及雪球状玻璃体混浊。诊断为肉芽肿性全葡萄膜炎,并给予局部类固醇治疗,两个月内病情好转。在此期间,未观察到神经功能恶化。MS中的肉芽肿性葡萄膜炎在文献中鲜有记载,但似乎在女性中更为常见,症状轻微或无症状,对局部类固醇治疗反应良好。

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