Ramyar Asghar, Shafiei Masoud, Moazzami Kasra, Rezaei Nima
Department of Pediatrics, Pediatrics Center of Excellence, Children's Medical Center, Iran.
Turk J Pediatr. 2010 Jul-Aug;52(4):423-5.
Hodgkin's disease can be cured in most cases by radiotherapy. However, it can increase the risk of cardiotoxicity. Here, we report a patient with Hodgkin's disease and superior vena cava syndrome who was treated with chemotherapy in combination with radiotherapy. Four months after the initiation of this therapy, she developed progressive dyspnea. Pleural and pericardial effusion, severe mitral regurgitation, moderate aortic insufficiency, and mild tricuspid regurgitation were detected in echocardiography, which suggested heart failure. The patient was then treated with intrapericardial drainage and received dopamine and diuretics for congestive heart failure; she responded well to this treatment and was discharged in good condition. After high-dose mediastinal radiation, cardiologic screening is recommended in order to identify patients with radiation-induced heart disease and to assess their need for treatment and follow-up.
大多数情况下，霍奇金淋巴瘤可通过放疗治愈。然而，放疗会增加心脏毒性风险。在此，我们报告1例患有霍奇金淋巴瘤和上腔静脉综合征的患者，其接受了化疗联合放疗。该治疗开始4个月后，她出现进行性呼吸困难。超声心动图检查发现有胸腔和心包积液、严重二尖瓣反流、中度主动脉瓣关闭不全及轻度三尖瓣反流，提示心力衰竭。随后该患者接受了心包内引流治疗，并因充血性心力衰竭接受多巴胺和利尿剂治疗；她对该治疗反应良好，出院时状况良好。在进行大剂量纵隔放疗后，建议进行心脏筛查，以识别患有放射性心脏病的患者，并评估他们的治疗及随访需求。
