股関節痛を主訴に受診した急性弛緩性脊髄炎の1 例

Abstract

急性弛緩性脊髄炎（ acute flaccid myelitis：AFM ）は，四肢の急性弛緩性麻痺を呈し，脊髄灰白質に病変を認める疾患であ る．今回我々は，通常と異なり股関節痛の精査目的に紹介受診となったAFM の症例を経験した．急速に進行する弛緩性麻痺 が主病態と考えられ，精査の結果AFM の診断に至った．ステロイドパルス，免疫グロブリン静注療法を行ったが明確な治療 効果は得られず，後遺症を残すに至った．四肢の疼痛を主訴とする場合，AFM も鑑別に挙げて精査することが重要である．そ れにより早期の診断治療および正確な疫学的データの蓄積を目指す必要がある．

Acute flaccid myelitis (AFM) is a disease that causes acute flaccid paralysis in the extremities similar to polio and has lesions in the spinal gray matter. We experienced a case of acute flaccid myelitis in a patient who visited the hospital for hip pain unlike the usual initial symptoms. The rapidly progressing flaccid paralysis was considered to be the main pathological condition, and a close examination led to the diagnosis of AFM. Although steroid pulse and intravenous immunoglobulin therapy were performed, a clear therapeutic effect was not obtained, and partial paralysis remained. When children have chief complaints of pain in the extremities, it is important to consider acute flaccid myelitis as an alternative diagnosis and carefully examine for paralytic symptoms. This may lead to early diagnostic treatment and may contribute to the accumulation of accurate epidemiological data.