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嗜酸性粒细胞增多导致的可逆性生物假体瓣膜血栓形成。

Reversible bioprosthetic valve thrombosis from eosinophilia.

作者信息

Kothari S S, Deepti Siddharthan, Rai Nitish

机构信息

Department of Cardiology, Cardio-Thoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India.

出版信息

BMJ Case Rep. 2018 Feb 8;2018:bcr-2017-222937. doi: 10.1136/bcr-2017-222937.

Abstract

A 31-year-old man with a mitral bioprosthetic valve presented with recent worsening of exertional dyspnoea 7 years after the mitral valve replacement. Evaluation revealed an increased gradient across the thickened mitral bioprosthetic valve leaflets. Marked eosinophilia was present and was considered as a putative cause for bioprosthetic valve thrombosis. The treatment with systemic corticosteroids and oral anticoagulation led to complete resolution of symptoms with significant decrease in mitral bioprosthetic valve gradient and leaflet thinning. The case is reported to highlight the fact that eosinophilia may cause reversible bioprosthetic valve thrombosis.

摘要

一名31岁男性,二尖瓣生物瓣置换术后7年,近期出现劳力性呼吸困难加重。评估显示增厚的二尖瓣生物瓣叶间压差增加。存在明显嗜酸性粒细胞增多,被认为是生物瓣血栓形成的可能原因。全身使用糖皮质激素和口服抗凝治疗后,症状完全缓解,二尖瓣生物瓣压差显著降低,瓣叶变薄。报道该病例以强调嗜酸性粒细胞增多可能导致可逆性生物瓣血栓形成这一事实。

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本文引用的文献

1
Bioprosthetic Valve Thrombosis.生物瓣血栓形成。
J Am Coll Cardiol. 2017 May 2;69(17):2193-2211. doi: 10.1016/j.jacc.2017.02.051.
4
Possible Subclinical Leaflet Thrombosis in Bioprosthetic Aortic Valves.
N Engl J Med. 2016 Apr 21;374(16):1591-2. doi: 10.1056/NEJMc1600179.
9
Cardiovascular manifestations of hypereosinophilic syndromes.嗜酸性粒细胞增多综合征的心血管表现。
Immunol Allergy Clin North Am. 2007 Aug;27(3):457-75. doi: 10.1016/j.iac.2007.07.001.

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