眼炎の鑑別

強膜炎やブドウ膜炎は意識して診療しないと見落とすことがあります

 

N Engl J Med 2019;380:1062-71.
DOI: 10.1056/NEJMcpc1810395

 

58歳女性 視力喪失 頭痛 口腔内潰瘍
診断:梅毒Syphilis

鑑別
眼炎を伴う全身性疾患

強膜炎Scleritisをきたす全身性疾患
Rheumatoid arthritis
Vasculitis, especially granulomatosis with polyangiitis
Inflammatory bowel disease
Relapsing polychondritis
Systemic lupus erythematosus
Ankylosing spondylitis
Behçet’s disease
Infection

強膜炎Scleritis・ブドウ膜炎Uveitisの両方をきたす全身性疾患
Inflammatory bowel disease
Relapsing polychondritis
Ankylosing spondylitis
Psoriatic arthritis
Behçet’s disease
Granulomatosis with polyangiitis
Eosinophilic granulomatosis with polyangiitis
Sarcoidosis

ブドウ膜炎Uveitisをきたす全身性疾患
Infection
Immune-mediated disease
Systemic disease
Clinical disease confined to the eye
Reaction to medication
Trauma
Syndromes that masquerade as uveitis (e.g., cancer)

ブドウ膜炎と中枢神経症状をきたす疾患
Primary CNS lymphoma
Infection
Acute retinal necrosis due to HSV, VZV, or CMV
Syphilis
Tuberculosis
Lyme disease
Whipple’s disease
HIV-1 infection
HTLV-1 infection
West Nile virus infection
Zika virus infection

Immune-mediated disease
Behçet’s disease
Sarcoidosis
Multiple sclerosis
Cogan’s syndrome
Vogt–Koyanagi–Harada syndrome
ANCA-associated vasculitis
Susac’s syndrome
Systemic lupus erythematosus
Neonatal-onset multisystem inflammatory disease
Antiphospholipid antibody syndrome