ステロイド大量投与が有効であった右下直筋腫大による右眼上転障害の１例

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A 47-year-old woman had suffered from diplopia with upward gaze for two months.Restriction of right eyeball elevation had been identified by a local ophthalmologist and was treated with oral administration of prednisolone. Since her diplopia did not improve, however, she visited our hospital. Laboratory data showed no evidence of inflammation or thyroid dysfunction.Orbital MRI showed right inferior rectal muscle swelling with enhancement after gadolinium administration.The patient was admitted to our hospital and treated with methylprednisolone pulse therapy three times weekly as well as with oral administration of dexamethasone. Four weeks after beginning treatment, her diplopia had improved and the right inferior rectal muscle had returned to normal size. The cause of the muscle swelling was not clear, but the possibility of euthyroid Graves’ophthalmopathy cannot be ruled out. Our experience suggests that even if the thyroid autoantibody is negative,the possibility of euthyroid Graves’ophthalmopathy remains,so that sufficient steroid administration is worth trying.
信州医学会の論文