Bilateral Panuveitis Associated With Hemophagocytic Lymphohistiocytosis: A Case Report

嗜血性淋巴組織球血症相關之雙眼全葡萄膜炎：病例報告

莊智鈞(Chih-Chun Chuang) ； 蕭靜熹(Ching-Hsi Hsiao) ； 林耕國(Ken-Kuo Lin) ； 陳冠任(Kuan-Jen Chen) ； 賴旗俊(Chi-Chun Lai) ； 黃奕修(Yih-Shiou Hwang)

《中華民國眼科醫學會雜誌》 48卷3期 (2009/12) Pp. 353-357

https://doi.org/10.30048/ACTASOS.200912.0019

摘要

目的：報告嗜血性淋巴組織球血症相關之雙眼全葡萄膜炎之病例。
方法：病例報告。
結果：一位72歲女性主訴為發燒、頭痛及呼吸喘，一星期後出現雙眼紅合併視力模糊，檢查發現病人有雙眼全葡萄膜炎。臨床症狀及骨髓切片證實診斷為嗜血性淋巴組織球血症。經過使用眼局部點用及靜脈注射皮質類固醇後，全葡萄膜炎及全身的症狀都得到緩解。
結論：嗜血性淋巴組織球血症可以與雙眼全葡萄膜炎相關，使用皮質類固醇眼藥水及靜脈注射皮質類固醇對於全葡萄膜炎及全身的症狀有治療效果。

並列摘要

Purpose: To report a case of bilateral panuveitis associated with hemophagocytic lymphohistiocytosis.
Method: Interventional case report.
Result: A 72-year-old woman presented with fever, headache and short=ness of breath, followed one week later by red eyes and blurred vision; she received comprehensive systemic and ophthalmological evaluation. The patient was found to have bilateral panuveitis. Systemic clinical signs and a bone marrow biopsy confirmed the diagnosis of hemophagocytic lymphohistiocytosis. The serum immunoglobulin G titer for Epstein-Barr virus was high (1:1280). Cultures and quantitative polymerase chain reactions of the intraocular fluids were negative for herpes virus, cytomegalovirus, varicella-zoster virus, and Epstein-Barr virus. The panuveitis and systemic symptoms subsided after treatment with systemic and topical corticosteroids.
Conclusion: Hemophagocytic lymphohistiocytosis could be associated with bilateral panuveitis. Topical and systemic corticosteroids may provide a favorable outcome as treatment for the panuveitis and systemic symptoms.

並列關鍵字

Corticosteroid ； Epstein-Barr virus EBV ； hemophagocytic lymphohistiocytosis HLH ； and panuveitis