Pearce Catharine, Hope Suzy, Butchart Joseph
Healthcare for Older People Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
Diabetes and Vascular Research Centre, University of Exeter Medical School, Exeter, UK.
BMJ Case Rep. 2018 Jan 29;2018:bcr-2017-221803. doi: 10.1136/bcr-2017-221803.
An 84-year-old woman presented with severe postural hypotension. Further assessment revealed weight loss, fatigue and fever at night. On examination, she had bilateral skin lesions on the inner thighs and skin biopsy revealed intravascular high grade B cell lymphoma. This was successfully treated with curative chemotherapy. The cause of the postural hypotension in this case was felt likely to be autonomic neuropathy caused by neurovascular infiltration by intravascular lymphoma. Treatment of the lymphoma has resolved the postural hypotension, although some symptoms of postural instability persist.
一名84岁女性出现严重体位性低血压。进一步评估发现体重减轻、疲劳和夜间发热。检查时，她双侧大腿内侧有皮肤病变，皮肤活检显示血管内高级别B细胞淋巴瘤。通过根治性化疗成功治疗了该病。该病例中体位性低血压的原因可能是血管内淋巴瘤神经血管浸润导致的自主神经病变。淋巴瘤的治疗已使体位性低血压得到缓解，尽管仍存在一些体位不稳的症状。
