Jameson Gayle S, Ramanathan Ramesh K, Borad Mitesh J, Downhour Molly, Korn Ronald, Von Hoff Daniel
Scottsdale Clinical Research Institute, TGen Clinical Research Services, Ariz., USA.
Case Rep Gastroenterol. 2009 Apr 15;3(1):67-71. doi: 10.1159/000207195.
Marantic endocarditis, otherwise known as nonbacterial thrombotic endocarditis (NBTE), is a well-documented phenomenon due to hypercoagulability from an underlying cause. It has been associated with a variety of inflammatory states including malignancy. Surprisingly, although hypercoagulability is often seen in patients with pancreatic cancer, marantic endocarditis has rarely been reported antemortem in this population. We report three cases of marantic endocarditis in patients with advanced pancreatic cancer. In two instances, the patients' neurological symptoms preceded the diagnosis of advanced pancreatic cancer. Health care professionals should be alert to the possibility of marantic endocarditis in any patient with cancer, especially pancreatic cancer, who presents with symptoms of neurological dysfunction or an arterial thrombotic event. Prompt diagnosis and treatment with heparin, unfractionated or low molecular weight, may prevent catastrophic CNS events and decrease morbidity in patients with pancreatic cancer and other malignancies.
消耗性心内膜炎，又称非细菌性血栓性心内膜炎（NBTE），是一种因潜在病因导致血液高凝状态而有充分文献记载的现象。它与包括恶性肿瘤在内的多种炎症状态有关。令人惊讶的是，尽管胰腺癌患者常出现高凝状态，但生前很少有该人群发生消耗性心内膜炎的报道。我们报告了3例晚期胰腺癌患者发生消耗性心内膜炎的病例。在2例中，患者的神经症状先于晚期胰腺癌的诊断出现。医疗保健专业人员应警惕任何患有癌症，尤其是胰腺癌且出现神经功能障碍症状或动脉血栓形成事件的患者发生消耗性心内膜炎的可能性。及时用普通肝素或低分子量肝素进行诊断和治疗，可能预防灾难性的中枢神经系统事件，并降低胰腺癌和其他恶性肿瘤患者的发病率。
