留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

隐匿型心脏结节病一例

赵玉月 王浩 朱朝晖 徐作军

赵玉月, 王浩, 朱朝晖, 徐作军. 隐匿型心脏结节病一例[J]. 协和医学杂志, 2019, 10(2): 185-188. doi: 10.3969/j.issn.1674-9081.2019.02.019
引用本文: 赵玉月, 王浩, 朱朝晖, 徐作军. 隐匿型心脏结节病一例[J]. 协和医学杂志, 2019, 10(2): 185-188. doi: 10.3969/j.issn.1674-9081.2019.02.019
Yu-yue ZHAO, Hao WANG, Zhao-hui ZHU, Zuo-jun XU. A Case of Sarcoidosis with Asymptomatic Cardiac Involvement[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 185-188. doi: 10.3969/j.issn.1674-9081.2019.02.019
Citation: Yu-yue ZHAO, Hao WANG, Zhao-hui ZHU, Zuo-jun XU. A Case of Sarcoidosis with Asymptomatic Cardiac Involvement[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 185-188. doi: 10.3969/j.issn.1674-9081.2019.02.019

隐匿型心脏结节病一例

doi: 10.3969/j.issn.1674-9081.2019.02.019
基金项目: 

国家重点研发计划 2016YFC0905700

国家自然科学基金面上项目 81670061

详细信息
    通讯作者:

    徐作军电话:010-69155039, E-mail: xuzj@hotmail.com

  • 中图分类号: R542.2

A Case of Sarcoidosis with Asymptomatic Cardiac Involvement

More Information
  • 摘要: 结节病是一种以非干酪样肉芽肿为特征的多系统受累性疾病,常见受累器官包括肺、心、眼、皮肤等。约2%~5%的结节病患者有心脏受累表现,有尸检研究显示结节病患者心脏受累发生率可高达25%~58%,但患者病情隐匿,常无心脏临床症状,容易漏诊或延误诊断,严重影响患者预后。本文报道一例隐匿型心脏结节病,分析其临床特征、实验室检查结果、诊治经过,提醒临床医生重视结节病患者的系统评估。
    利益冲突  无
  • 图  1  2013年患者胸部CT可见纵隔多发淋巴结肿大(A,箭头),双肺散在结节(B,箭头);2016年胸部CT示淋巴结数量较前减少、体积缩小(C),肺内结节消失(D)

    图  2  患者18F-氟脱氧葡萄糖正电子发射断层显像示全身多发高代谢影(2016年)

    图  3  患者13N-氨水心脏正电子发射断层显像-磁共振成像示心肌对氨水摄取不均匀(2016年)

  • [1] Valeyre D, Prasse A, Nunes H, et al. Sarcoidosis[J]. Lancet, 2014, 383: 1155-1167. doi:  10.1016/S0140-6736(13)60680-7
    [2] Dubrey SW, Falk RH. Diagnosis and management of cardiac sarcoidosis[J]. Prog Cardiovasc Dis, 2010, 52: 336-346. doi:  10.1016/j.pcad.2009.11.010
    [3] Ardehali H, Howard DL, Hariri A, et al. A positive endomyocardial biopsy result for sarcoid is associated with poor prognosis in patients with initially unexplained cardiomyopathy[J]. Am Heart J, 2005, 150: 459-463. doi:  10.1016/j.ahj.2004.10.006
    [4] Iwai K, Takemura T, Kitaichi M, et al. Pathological studies on sarcoidosis autopsy Ⅱ. Early change, mode of progression and death pattern[J]. Acta Pathol Jpn, 1993, 43: 377-385. doi:  10.1111/j.1440-1827.1993.tb01149.x
    [5] Birnie DH, Kandolin R, Nery PB, et al. Cardiac manifestations of sarcoidosis: diagnosis and management[J]. Eur Heart J, 2017, 38:2663-2670.
    [6] Cooper LT, Baughman KL, Feldman AM, et al. The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology. Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology[J]. J Am Coll Cardiol, 2007, 50: 1914-1931. doi:  10.1016/j.jacc.2007.09.008
    [7] Simonen P, Lehtonen J, Kandolin R, et al. F-18-fluorodeoxyglucose positron emission tomography-guided sampling of mediastinal lymph nodes in the diagnosis of cardiac sarcoidosis[J]. Am J Cardiol, 2015, 116: 1581-1585. doi:  10.1016/j.amjcard.2015.08.025
    [8] Ishimaru S, Tsujino I, Takei T, et al. Focal uptake on 18F-fluoro-2-deoxyglucose positron emission tomography images indicates cardiac involvement of sarcoidosis[J]. Eur Heart J, 2005, 26: 1538-1543. doi:  10.1093/eurheartj/ehi180
    [9] Blankstein R, Osborne M, Naya M, et al. Cardiac positron emission tomography enhances prognostic assessments of patients with suspected cardiac sarcoidosis[J]. J Am Coll Cardiol, 2014, 63: 329-336. doi:  10.1016/j.jacc.2013.09.022
    [10] Birnie DH, Sauer WH, Bogun F, et al. HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis[J]. Heart Rhythm, 2014, 11: 1304-1323. doi:  10.1016/j.hrthm.2014.03.043
    [11] Nery PB, Beanlands RS, Nair GM, et al. Atrioventricular block as the initial manifestation of cardiac sarcoidosis in middle-aged adults[J]. J Cardiovasc Electrophysiol, 2014, 25: 875-881. doi:  10.1111/jce.12401
    [12] Kumar S, Barbhaiya C, Nagashima K, et al. Ventricular tachycardia in cardiac sarcoidosis: characterization of ventricular substrate and outcomes of catheter ablation[J]. Circ Arrhythm Electrophysiol, 2015, 8: 87-93. doi:  10.1161/CIRCEP.114.002145
    [13] Jeudy J, Burke AP, White CS, et al. Cardiac sarcoidosis: the challenge of radiologic-pathologic correlation: from the radiologic pathology archives[J]. Radiographics, 2015, 35: 657-679. doi:  10.1148/rg.2015140247
    [14] Baughman RP, Engel PJ, Nathan S. Pulmonary Hypertension in Sarcoidosis[J]. Clin Chest Med, 2015, 36: 703-714. doi:  10.1016/j.ccm.2015.08.011
    [15] Kinney E, Murthy R, Ascunce G, et al. Pericardial effusions in sarcoidosis[J]. Chest, 1979, 76: 476-478. doi:  10.1378/chest.76.4.476
    [16] Barton JH, Tavora F, Farb A, et al. Unusual cardiovascular manifestations of sarcoidosis, a report of three cases: coronary artery aneurysm with myocardial infarction, symptomatic mitral valvular disease, and sudden death from ruptured splenic artery[J]. Cardiovasc Pathol, 2010, 19: e119-e123. doi:  10.1016/j.carpath.2009.04.006
    [17] Weiler V, Redtenbacher S, Bancher C, et al. Concurrence of sarcoidosis and aortitis: case report and review of the literature[J]. Ann Rheum Dis, 2000, 59: 850-853. doi:  10.1136/ard.59.11.850
    [18] Hulten E, Aslam S, Osborne M, et al. Cardiac sarcoidosis-state of the art review[J]. Cardiovasc Diagn Ther, 2016, 6: 50-63.
    [19] Hunninghake GW, Costabel U, Ando M, et al. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoido-sis and other Granulomatous Disorders[J]. Sarcoidosis Vasc Diffuse Lung Dis, 1999, 16: 149-173.
    [20] Young L, Sperry BW, Hachamovitch R. Update on Treatment in Cardiac Sarcoidosis[J]. Curr Treat Options Cardiovasc Med, 2017, 19: 47. doi:  10.1007/s11936-017-0539-1
    [21] Fahim A, Mann JS. Pulmonary sarcoidosis: diagnostic and treatment update[J]. Expert Rev Respir Med, 2014, 8: 493-501. doi:  10.1586/17476348.2014.919225
    [22] Baughman RP, Iannuzzi MC, Lower EE, et al. Use of fluticasone in acute symptomatic pulmonary sarcoidosis[J]. Sarcoidosis Vasc Diffuse Lung Dis, 2002, 19: 198-204. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=3beb634e52caab39af58b7cc71826b52
  • 加载中
图(3)
计量
  • 文章访问数:  544
  • HTML全文浏览量:  58
  • PDF下载量:  124
  • 被引次数: 0
出版历程
  • 收稿日期:  2017-12-14
  • 刊出日期:  2020-09-18

目录

    /

    返回文章
    返回

    【温馨提醒】近日,《协和医学杂志》编辑部接到作者反映,有多名不法人员冒充期刊编辑发送见刊通知,鼓动作者添加微信,从而骗取版面费的行为。特提醒您,本刊与作者联系的方式均为邮件通知或电话,稿件进度通知邮箱为:mjpumch@126.com,编辑部电话为:010-69154261,请提高警惕,谨防上当受骗!如有任何疑问,请致电编辑部核实。谢谢!