소아에서 급성 눈물샘염으로 발현된 비특이성안와염 1예
Idiopathic Orbital Inflammation Presenting as Unilateral Dacryoadenitis in a Child
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목적: 소아 연령에서 드물게 발생되는 급성 눈물샘염으로 발현된 비특이성안와염을 경험하였기에 보고하고자 한다. 증례요약: 9세 환아가 5일간의 발적, 압통을 동반한 우측 눈꺼풀 부종 및 이측 결막 충혈을 주소로 내원하였다. 발열 등 전신 증상은없었으며, 안와연조직염 의심하에 전신적 항생제 치료를 시행하였으나 반응이 없었고 안와 전산화단층촬영 및 자기공명영상에서 우측눈물샘의 염증성 비대 소견과 함께 스테로이드 치료에 잘 반응하여 비특이성안와염으로 인한 급성 눈물샘염으로 진단되었다. 2개월간의 스테로이드 감량치료 후 염증이 소실되었으며 4개월의 경과 관찰 시 재발소견은 없었다. 결론: 일측성으로 발생된 눈꺼풀 부종 및 발적 시 소아에서 흔히 안와연조직염을 의심할 수 있으나 감별질환으로 비특이성안와염의일종인 급성 눈물샘염을 고려해 보아야 한다.
Abstract
Purpose: To report a case of idiopathic orbital inflammation presenting as unilateral acute dacryoadenitis in a child. Case Summary: A nine-year-old boy presented with painful swelling and redness in the right upper eyelid and temporal conjunctiva without systemic symptoms for five days. Acute orbital cellulitis was suspected but did not respond to systemic antibiotics. An orbital computed tomogram and magnetic resonance imaging revealed a diffusely enlarged and inflamed right lacrimal gland. The patient showed dramatic response to systemic corticosteroids, and acute dacryoadenitis due to idiopathic orbital inflammation was diagnosed. Treatment with oral corticosteroids for two months resolved the inflammation. No relapse was observed during four months of follow-up. Conclusions: Although rare, acute dacryoadenitis as a localized nonspecific orbital inflammation should be considered in the differential diagnosis of acute orbital cellulitis in pediatric patients.
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