Dedieu Natalie, Giardini Alessandro, Khambadkone Sachin, Marek Jan
Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, WC1N 3JH London, UK.
Eur J Echocardiogr. 2011 Jan;12(1):E3. doi: 10.1093/ejechocard/jeq098. Epub 2010 Aug 20.
A 12-year-old child with no previous medical history was referred with a 4-day history of cough, shortness of breath, and peripheral blood eosinophilia. Transthoracic echocardiography showed a soft tissue infiltrating the left ventricular free wall, the lateral mitral annulus, and the mitral valve leaflets. A soft tissue strand connecting the lateral left atrial wall and mitral leaflets across the mitral valve orifice was also identified, causing reduced opening and functional mitral stenosis. The diagnosis of Löeffler endocarditis was made, and after 10 weeks of treatment with oral prednisolone, there was complete resolution of symptoms and of the infiltrative tissue with normalization of mitral valve function. The present case highlights some atypical features of eosinophilic heart disease-like occurrence in paediatric age, the complete preservation of the right ventricle and left ventricular apex, and the presentation with mitral stenosis compared with mitral regurgitation typically observed in the late phase of the disease.
一名既往无病史的12岁儿童因咳嗽、气短和外周血嗜酸性粒细胞增多4天前来就诊。经胸超声心动图显示,软组织浸润左心室游离壁、二尖瓣外侧瓣环和二尖瓣叶。还发现一条软组织束穿过二尖瓣口连接左心房外侧壁和二尖瓣叶,导致二尖瓣开口减小和功能性二尖瓣狭窄。诊断为吕弗勒心内膜炎,口服泼尼松龙治疗10周后,症状完全缓解,浸润组织消失,二尖瓣功能恢复正常。本病例突出了嗜酸性粒细胞性心脏病在儿童期出现的一些非典型特征,右心室和左心室心尖完全保留,以及与该病晚期通常观察到的二尖瓣反流相比,以二尖瓣狭窄为表现。