Helsen V, Decoutere L, Spriet I, Fagard K, Boonen S, Tournoy J
Division of Gerontology and Geriatrics, Katholieke Universiteit Leuven, Leuven, Belgium.
Acta Clin Belg. 2013 Mar-Apr;68(2):113-5. doi: 10.2143/ACB.3138.
A 83-year-old woman was admitted to hospital with chest pain, fever, dry cough and palpitations. Chest X-ray revealed a pleural effusion, assumed to be caused by cardiac failure and respiratory infection. Despite treatment with antibiotics and diuretics, the pleural effusion increased on chest X-ray and there were signs of pleural and pericardial effusion on computed tomography (CT) scan. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) was not successful. Meanwhile patients' long-term use of ergotamine for migraine was revealed, which is associated with pleuropulmonary and cardiac fibrotic reactions. Tentative treatment with colchicine was successful, with complete resolution of pleural fluid, fever, cough and inflammatory parameters. This case highlights the importance of establishing an ergot alkaloid use registry in unexplained pleuropericardial effusions and supports the use of colchicine as a potential therapeutic approach.
一名83岁女性因胸痛、发热、干咳和心悸入院。胸部X线显示胸腔积液，推测由心力衰竭和呼吸道感染引起。尽管使用了抗生素和利尿剂治疗，但胸部X线显示胸腔积液仍增多，计算机断层扫描（CT）显示有胸膜和心包积液迹象。使用非甾体抗炎药（NSAIDs）治疗未成功。同时发现患者长期使用麦角胺治疗偏头痛，这与胸膜肺和心脏纤维化反应有关。秋水仙碱试验性治疗成功，胸腔积液、发热、咳嗽和炎症指标完全消退。该病例强调了在不明原因的胸膜心包积液中建立麦角生物碱使用登记册的重要性，并支持将秋水仙碱作为一种潜在的治疗方法。
