Kobayashi Toshiyuki, Tadokoro Hiroshi, Matsumoto Koshi
Department of Internal Medicine, Ebina General Hospital, Japan.
Intern Med. 2013;52(12):1369-73. doi: 10.2169/internalmedicine.52.9351.
A woman over 70 years of age presented with anemia and appetite loss. She had no history of blood transfusions, although she had been receiving iron infusions for anemia for seven years. She had an elevated serum ferritin level (7,951 ng/mL) one month before admission. Abdominal computed tomography showed increased hepatic density and echocardiography showed normal heart valves and heart-wall motion. The patient eventually experienced atrial tachycardia and atrial fibrillation and died of heart failure. An autopsy revealed iron deposits in the liver, pancreas, adrenal glands, thyroid gland, gastric mucosa and myocardium. Iron-overload cardiomyopathy was diagnosed based on the iron deposits, myocardial disarray and interstitial fibrosis.
一名70多岁的女性出现贫血和食欲减退症状。她没有输血史,尽管她因贫血接受铁剂输注已有七年。入院前一个月,她的血清铁蛋白水平升高(7951 ng/mL)。腹部计算机断层扫描显示肝脏密度增加,超声心动图显示心脏瓣膜和心肌壁运动正常。患者最终出现房性心动过速和心房颤动,并死于心力衰竭。尸检发现肝脏、胰腺、肾上腺、甲状腺、胃黏膜和心肌中有铁沉积。根据铁沉积、心肌排列紊乱和间质纤维化诊断为铁过载心肌病。