Kawakami Y, Nakayama Y, Nagao H, Hirota Y, Kawamura K
Department of Internal Medicine, Osaka Medical College.
Kokyu To Junkan. 1991 Sep;39(9):935-8.
A 23-year-old-man was admitted to our department complaining of chest oppression. He had had a diagnosis of intestinal-Behçet because of a 7-year history of recurrent oral and genital ulcers, arthritis, cutaneous folliculitis and ulcer in the ileocecal region. Cardiac catheterization revealed total occlusion at the proximal portion of the left anterior descending artery (LAD) without aneurysm formation at other coronary trees. During medical follow-up, this case showed vasospastic angina probably associated with active coronary vasculitis. The incidence of vascular involvement in the total number of cases of Behçet's disease reported in the literature is 3.6-7.7%. Overall, thrombophlebitis and arterial aneurysm formation is relatively common and frequently reported in cases of vasculo-Behçet. Our case demonstrated the following uncommon pattern as vasculo-Behçet; 1) initial clinicopathologic manifestation at the coronary artery without any other vascular lesion, 2) abrupt total occlusion (clear cut lesion) at LAD, 3) complication of vasospastic angina, which has not yet been reported in medical literature.
一名23岁男性因胸部压迫感入院。他因有7年复发性口腔和生殖器溃疡、关节炎、皮肤毛囊炎及回盲部溃疡病史,被诊断为肠型白塞病。心脏导管检查显示左前降支(LAD)近端完全闭塞,其他冠状动脉树未形成动脉瘤。在医学随访期间,该病例表现为可能与活动性冠状动脉血管炎相关的血管痉挛性心绞痛。文献报道的白塞病病例中血管受累的发生率为3.6 - 7.7%。总体而言,血栓性静脉炎和动脉瘤形成在血管型白塞病病例中相对常见且报道频繁。我们的病例表现出血管型白塞病以下不常见的模式:1)冠状动脉最初的临床病理表现,无任何其他血管病变;2)LAD突然完全闭塞(明确病变);3)血管痉挛性心绞痛并发症,医学文献中尚未有报道。