Divisions of Cardiology, Cardiac Surgery and Nursing, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Can J Cardiol. 2013 Sep;29(9):1138.e7-8. doi: 10.1016/j.cjca.2012.12.011. Epub 2013 Mar 6.
A young woman thought to have seronegative rheumatoid arthritis developed Stevens-Johnson syndrome after treatment with sulfasalazine; this resolved with prednisone. Later she was found to be HLA-B27-positive in keeping with a spondyloarthropathy. Soon afterward, she developed clinical myopericarditis and cardiogenic shock that responded initially to methylprednisolone and intravenous immunoglobulin, but recurred. An endomyocardial biopsy demonstrated active myocarditis with a mixed cell composition including rare giant cells, but not enough to classify it as giant cell myocarditis. Heart failure symptoms returned and she eventually required a heart transplant; the explanted heart showed giant cell myocarditis.
一位年轻女性被认为患有血清阴性类风湿关节炎，在使用柳氮磺胺吡啶治疗后出现史蒂文斯-约翰逊综合征；经泼尼松治疗后缓解。后来，她被发现 HLA-B27 阳性，符合脊柱关节病。此后不久，她出现临床心肌心包炎和心源性休克，最初对甲基强的松龙和静脉注射免疫球蛋白有反应，但又复发。心肌内膜活检显示活动性心肌炎，细胞成分混合，包括罕见的巨大细胞，但不足以将其归类为巨细胞心肌炎。心力衰竭症状再次出现，最终她需要进行心脏移植；移植心脏显示巨细胞心肌炎。
