Suzuki Yuji, Nishiyama Osamu, Sakai Toshiaki, Niiyama Masanobu, Itoh Tomonori, Nakamura Motoyuki
Department of Cardiology, Iwate Prefectural Ninohe Hospital, Japan.
Intern Med. 2014;53(7):717-20. doi: 10.2169/internalmedicine.53.0446. Epub 2012 Mar 1.
A 42-year-old woman with a history of aspirin-induced asthma was admitted with severe chest pain. Emergency coronary angiography revealed coronary artery spasms. The administration of vasodilators did not suppress the anginal symptoms, and the differential white blood cell count continued to show eosinophilia. The patient's symptoms of aspirin-induced asthma, eosinophilia and other allergic states led to the diagnosis of Churg-Strauss syndrome (CSS). After starting betamethasone therapy, the eosinophilia and cardiac symptoms rapidly disappeared. Although coronary vasospasms related to CSS are rare, the present case suggests that a differential white blood cell count should be obtained in patients with refractory coronary vasospasms.
一名有阿司匹林诱发哮喘病史的42岁女性因严重胸痛入院。急诊冠状动脉造影显示冠状动脉痉挛。使用血管扩张剂未能抑制心绞痛症状，白细胞分类计数持续显示嗜酸性粒细胞增多。患者的阿司匹林诱发哮喘、嗜酸性粒细胞增多及其他过敏状态症状导致诊断为变应性肉芽肿性血管炎（CSS）。开始使用倍他米松治疗后，嗜酸性粒细胞增多及心脏症状迅速消失。虽然与CSS相关的冠状动脉痉挛很少见，但本病例提示，对于难治性冠状动脉痉挛患者应进行白细胞分类计数检查。
