Sarlon G, Durant C, Grandgeorge Y, Bernit E, Veit V, Hamidou M, Schleinitz N, Harlé J-R
Service de chirurgie et médecine vasculaire, faculté de médecine de Marseille, université de la méditerranée, hôpital La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
Rev Med Interne. 2010 Feb;31(2):135-9. doi: 10.1016/j.revmed.2009.06.007. Epub 2009 Sep 23.
Discordance exists between the results of post-mortem studies and the low number of clinical reported cases of cardiac involvements in Wegener's granulomatosis.
Data from four patients were studied retrospectively. Three patients had associated airway localization and three had kidney involvement. All patients had positive test for anti-PR3 antineutrophil antibodies. Two patients presented with dilated cardiomyopathy (one with terminal cardiac failure), another patient with complete atrioventricular block and pericarditis, and the remaining one with myopericarditis. One patient was asymptomatic. For three of these patients, the cardiac manifestations were contemporary of the diagnosis of Wegener's granulomatosis and had a severe disease course.
Cardiac events in Wegener's granulomatosis are probably underestimated, given the various type of heart damage and the clinical presentation. Cardiac involvement seems to be associated with a poor prognosis. Thus, we recommend systematic and regular cardiac assessment in the follow-up of patients with Wegener's granulomatosis.
尸检研究结果与韦格纳肉芽肿心脏受累临床报告病例数较少之间存在不一致。
对4例患者的数据进行回顾性研究。3例患者伴有气道定位,3例有肾脏受累。所有患者抗PR3抗中性粒细胞抗体检测均为阳性。2例患者出现扩张型心肌病(1例伴有终末期心力衰竭),另1例患者出现完全性房室传导阻滞和心包炎,其余1例患者出现心肌心包炎。1例患者无症状。其中3例患者的心脏表现与韦格纳肉芽肿诊断同时出现,且病程严重。
鉴于心脏损害的多种类型和临床表现,韦格纳肉芽肿的心脏事件可能被低估。心脏受累似乎与预后不良有关。因此,我们建议在韦格纳肉芽肿患者的随访中进行系统和定期的心脏评估。