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严重心肌病揭示抗中性粒细胞胞浆抗体阴性的嗜酸性肉芽肿性多血管炎。

Severe cardiomyopathy revealing antineutrophil cytoplasmic antibodies-negative eosinophilic granulomatosis with polyangiitis.

作者信息

Bouiller K, Samson M, Eicher J-C, Audia S, Berthier S, Leguy V, Humbert O, Martin L, Lorgis L, Cottin Y, Bonnotte B, Lorcerie B

机构信息

Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, France.

出版信息

Intern Med J. 2014 Sep;44(9):928-31. doi: 10.1111/imj.12525.

Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare form of systemic vasculitis in which cardiac involvement is frequent and severe, and accounts for half of EGPA-related deaths. ANCA-positive EGPA differs from ANCA-negative EGPA in that the former is significantly associated with renal involvement, peripheral neuropathy and biopsy proven vasculitis, whereas the latter is associated with cardiac involvement. Herein, we report a case of EGPA with myocarditis in a woman, who was successfully treated with steroids and cyclophosphamide. This report highlights the importance of diagnosing cardiac involvement in EGPA early, especially in ANCA-negative patients.

摘要

嗜酸性粒细胞性肉芽肿伴多血管炎(EGPA)是一种罕见的系统性血管炎,心脏受累常见且严重,占EGPA相关死亡病例的一半。抗中性粒细胞胞浆抗体(ANCA)阳性的EGPA与ANCA阴性的EGPA不同,前者与肾脏受累、周围神经病变及活检证实的血管炎显著相关,而后者与心脏受累相关。在此,我们报告一例患有心肌炎的女性EGPA病例,该患者接受类固醇和环磷酰胺治疗后痊愈。本报告强调了早期诊断EGPA心脏受累的重要性,尤其是在ANCA阴性的患者中。

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