갑상선 기능항진증과 동반된 양안 재발성 후공막염 1예
A Case of Recurrent Posterior Scleritis With Hyperthyroidism in Both Eyes
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목적: 후공막염은 드문 질환으로 알려져 있다. 갑상선 기능항진증을 동반한 환자의 단안에서 발생하여 1년 만에 반대편 눈에 재발한 후공막염 1예를 경험하고 이에 대한 보고를 하고자 한다. 증례요약: 39세 여자환자가 좌안의 안구동통과 두통을 주소로 내원하였다. 안저 검사, 초음파검사, CT 및 MRI 검사 등을 이용해 후공막 염으로 진단하고 Methylprednisolone을 경구투여 조치를 하여 효과적인 치료결과를 얻었다. 퇴원 후 4개월 뒤에 갑상선유두암으로 좌측 갑상선부분절제술을 시행받은 뒤 그로부터 7개월 뒤 1주일간의 우안의 안구동통과 두통으로 다시 내원한 환자를 안저검사, 초음 파검사, MRI 검사의 임상소견 결과로 후공막염으로 진단하였다. Methylprednisolone을 경구투여 조치 후 효과적인 치료결과를 얻었고 환자는 퇴원 후 5개월까지 경과관찰하였으나 재발의 소견은 보이지 않았다. 결론: 갑상선 기능항진증 환자에서 안구동통이나 두통이 있을 때 후공막염의 동반 가능성을 생각해 볼 수 있고, 후공막염의 진단 후에 도 양안에 재발이 가능하다는 점을 염두에 두어야 할 것으로 판단된다.
Abstract
Purpose: Posterior scleritis is known to be a rare disease. The authors of the present study herein report a case of posterior scleritis, which occurred in a patient’s eye, accompanied by hyperthyroidism and recurring in the other eye one year later. Case summary: A 39-year-old female patient visited the hospital for ocular pain in the left eye and a headache. The patient was diagnosed with posterior scleritis through fundus examination, ultrasonography, CT and MRI, and an effective outcome of treatment was obtained by oral administration of methylprednisolone. Four months after discharge, the patient received left subtotal thyroidectomy for thyroid papillary cancer. Seven months after surgery she visited again, due to ocular pain that started 1 week earlier in the left eye, as well as a headache, and was diagnosed with posterior scleritis upon fundus examination, ultrasonography and MRI. Methylprednisolone was administered orally and an effective treatment result was obtained. After discharge, the patient was followed up for 5 months and did not show any signs of recurrence. Conclusions: When a hyperthyroidism patient has ocular pain or a headache, the possibility of posterior scleritis accompaniment should be considered, as well as the possibility that posterior scleritis, which already occurred in one eye, may recur in the other eye.
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