Azevedo Luísa, Costa Mariana Reis, Fonseca Ana Catarina, Pinho e Melo Teresa
Department of Neurosciences and Mental Health, Stroke Unit, Lisboa, Portugal.
BMJ Case Rep. 2016 Feb 4;2016:bcr2015213603. doi: 10.1136/bcr-2015-213603.
The authors present a case of a 28-year-old man with a known history of paroxysmal nocturnal haemoglobinuria (PNH), under platelet antiaggregation, admitted following recurrent transitory arterial ischaemic attacks. Concomitant thrombosis of the superior mesenteric artery and bilateral renal infarction was found. Cardioembolism, namely patent foramen ovale, was excluded and anticoagulation added, with no further events on 10-month follow-up. PNH is a rare acquired disorder of haematopoietic stem cells, characterised by haemolytic anaemia, pancytopenia and thrombotic events classically involving the venous system. Reports of cerebral artery stroke and accompanying intra-abdominal arterial thrombosis are especially rare. Complementary investigation and treatment options in these patients are discussed.
作者报告了一例28岁男性患者，该患者有阵发性夜间血红蛋白尿（PNH）病史，正在接受血小板抗聚集治疗，因反复短暂性动脉缺血性发作入院。检查发现伴有肠系膜上动脉血栓形成和双侧肾梗死。排除了心源性栓塞，即卵圆孔未闭，并加用了抗凝治疗，在10个月的随访中未再发生其他事件。PNH是一种罕见的造血干细胞获得性疾病，其特征为溶血性贫血、全血细胞减少和血栓形成事件，典型情况累及静脉系统。脑动脉卒中及伴有腹内动脉血栓形成的报告尤为罕见。本文讨论了这些患者的辅助检查及治疗选择。
