Amiya Eisuke, Ishizaka Nobukazu, Watanabe Airi, Endo Yoko, Itou Rei, Yoshida Shigetaka, Nangaku Masahumi, Nagai Ryozo
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Circ J. 2005 Jun;69(6):760-2. doi: 10.1253/circj.69.760.
A 66-year old man, who had been diagnosed with dilated cardiomyopathy and felt a progressive shortness of breath and fatigability, was admitted to hospital. Computed tomography showed a thickening of the aortic wall from the aortic arch to the aortic bifurcation, as well as mild pleural and pericardial effusion. Intravenous pyelography showed severe ureteral stenosis, along with hydronephrosis, of the left side. There was a marked increase in C-reactive protein and the erythrocyte sedimentation rate, but the serology for connective tissue disease and perinuclear antineutrophil cytoplasmic antibodies was negative. Retroperitoneal fibrosis (RPF) with intrathoracic extension was diagnosed. After confirming the absence of malignant disease, an oral predonisolone treatment of 30 mg/day was started, and this ameliorated the ureteral obstruction, aortic wall thickening and pericardial effusion. The patient had been taking 300 mg of loxoprofen sodium for headaches every day for 16 years. The relationship between loxoprofen, cardiomyopathy and RPF remains unclear. There is a possibility of RPF in the patients with a thickening of thoracic aortic wall, as in this case.
一名66岁男性，此前被诊断为扩张型心肌病，且感到进行性气短和乏力，遂入院治疗。计算机断层扫描显示从主动脉弓到主动脉分叉处的主动脉壁增厚，以及轻度胸腔和心包积液。静脉肾盂造影显示左侧输尿管严重狭窄并伴有肾积水。C反应蛋白和红细胞沉降率显著升高，但结缔组织病和核周抗中性粒细胞胞浆抗体的血清学检查结果为阴性。诊断为伴有胸腔内蔓延的腹膜后纤维化（RPF）。在确认无恶性疾病后，开始口服泼尼松龙，剂量为每日30毫克，这改善了输尿管梗阻、主动脉壁增厚和心包积液。该患者16年来每天服用300毫克洛索洛芬钠治疗头痛。洛索洛芬、心肌病和RPF之间的关系尚不清楚。如本病例所示，胸主动脉壁增厚的患者有可能发生RPF。
