抄録
声門下血管腫は新生児期あるいは乳児期早期に重篤な気道閉塞症状を呈する稀な疾患である.今回我々は,乳児期に喘鳴を主訴に来院しステロイド全身投与が著効を呈した2例を経験したので報告する.症例1は2か月の女児,生後1か月より喘鳴を認め,徐々に増悪したため当科に紹介された.造影CTと気管支鏡で声門下血管腫と診断した.症例2は3か月の男児.出生時より喘鳴を認め,生後3か月時に陥没呼吸が出現したため当院紹介された.造影CTおよび気管支鏡で声門下血管腫と診断した.いずれの症例もプレドニゾロンを2mg/kg/日の全身投与を開始したところ,呼吸器症状は約1週間で消失した.CTで腫瘤の著明な縮小を認めた.それぞれ投与後3年,10か月経過しているがステロイドの投与なしで,症状の再燃も認めていない.ステロイド全身投与は声門下血管腫に対する低侵襲かつ有効な治療法と考えられた.
Subglottic hemangioma is a rare airway disease which is usually presented with severe airway obstruction in the 1st year of life. We report two cases of subglottic hemangioma treated with systemic corticosteroids. Case 1: A 2-month-old infant was referred to our institution due to biphasic stridor. An enhanced CT scan and bronchoscopy revealed a subglottic hemangioma. Case 2: A 3-month-old infant was referred to our institution due to biphasic stridor and retraction. An enhanced CT scan and bronchoscopy revealed a subglottic hemangioma. Both patients were treated with systemic corticosteroids. The initial dosage of prednisolone was 2mg/kg/day. Marked improvement of respiratory symptoms was observed within a week after the steroid therapy started. To date, they are free from respiratory symptoms without steroid therapy. These cases suggest that systemic administration of corticosteroids is useful in the treatment of airway obstruction due to subglottic hemangioma.
