Parquet Carlos A, Curotto-Grasiosi Jorge, Machado Rogelio A, Peressotti Bruno, Padilla Matías B, Bolaño Alberto L
Servicio de Cardiología, Hospital Militar Central, Buenos Aires, Argentina.
Rev Med Inst Mex Seguro Soc. 2017 Mar-Apr;55(2):247-251.
A 29-year-old man with a history of seizures, was admitted due to an episode of unconsciousness recovered and hypertension with renal disfunction. The electrocardiogram mimicked a hypertrophic cardiomyopathy, but, by Doppler echocardiography, this was discarded because it suggested endomyocardial fibrosis which was confirmed by cardiac magnetic resonance imaging with late enhancement. Since the episode of unconsciousness, brain imaging studies were performed showing vascular sequelae and microangiopathic lesions. These vascular lesions asocciated with renal disfunction with proteinuria within nephrotic range, intensified the search for the etiology arriving to the diagnosis of antiphospholipid syndrome. The patient was discharged with antihypertensive therapy, acenocoumarol, antiepileptic and immunosuppressive drugs.
一名有癫痫病史的29岁男性，因一次意识丧失后恢复以及伴有肾功能不全的高血压入院。心电图表现类似肥厚型心肌病，但经多普勒超声心动图检查后排除了该诊断，因为超声心动图提示心内膜纤维化，而心脏磁共振成像延迟强化检查证实了这一点。自意识丧失发作后，进行了脑部影像学检查，发现有血管后遗症和微血管病变。这些血管病变与肾功能不全及肾病范围的蛋白尿相关，促使进一步寻找病因，最终诊断为抗磷脂综合征。患者出院时使用了抗高血压药物、醋硝香豆素、抗癫痫药物和免疫抑制药物。
