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小丑症候群合併血管運動性鼻炎

Harlequin Syndrome with Vasomotor Rhinitis

摘要


小丑症候群是一種相當罕見的疾病,可能是一側面部交感神經功能異常,在受熱刺激或運動過後,僅對側面部會出現潮紅的現象。一47歲男性,因每日午後發作左側鼻塞、左臉潮紅及脹痛半年求診於本院。理學檢查無異常發現,下午發病時的磁振造影呈現左側鼻竇黏膜腫脹,但上午未發病時的鼻竇電腦斷層居然無異常發現,遂建議類固醇鼻噴劑、抗組織胺及陣熱解痛劑等保守治療。1個月後,左側鼻塞及臉部脹痛已經消失,但爾後兩年,左臉潮紅依然於每日午後發作。因此,若遇反覆發作的單側臉紅腫合併該側鼻及鼻竇炎時,需考慮可能是小丑症候群合併血管運動性鼻炎,治療宜保守。

並列摘要


Harlequin syndrome is a rare disease. It is probable that the unilateral facial sympathetic nerve dysfunction leads to contralateral facial flushing. A 47-year-old male presented left nasal stuffiness, left facial flushing and painful swelling every afternoon for half a year. Physical examination was unremarkable. The magnetic resonance image showed mucosal thickening of the left sinuses in the afternoon; however, the computed tomography of nasal cavities and sinuses did not show any abnormality when he was uneventful in the morning. Steroid nasal spray, antihistamine, and analgesic were recommended. One month later, the left nasal stuffiness and left facial painful swelling subsided; however, the left facial flushing recurred every afternoon over the following two years. Therefore, the recurrent unilateral facial flushing and the ipsilateral rhinosinusitis may attribute to harlequin syndrome and vasomotor rhinitis. Conservative treatment is recommended.

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