Alarfaj Sumaiah Jamal, Al-Mehisen Rabah, Elhag Imad, Kazzaz Nayef Mohammed
Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Division of Cardiology, Department of Internal Medicine, Security Forces Hospital Program, Riyadh, Saudi Arabia.
BMJ Case Rep. 2018 Oct 17;2018:bcr-2018-226052. doi: 10.1136/bcr-2018-226052.
A 35-year-old black Saudi man, with a known case of bronchial asthma and allergic rhinitis since childhood, presented with joint pain and swelling, orthopnoea, paroxysmal nocturnal dyspnoea and lower extremity oedema. On examination, we found jugular venous distension, bilateral basal crepitation, wheezing and diffuse synovitis. Investigations were notable for peripheral blood eosinophilia, pericardial effusion and elongated structure in the left ventricular outflow tract on echocardiography, mediastinal and hilar lymphadenopathy and right upper lobe infiltrate on high-resolution CT scan. Pulmonary infiltrate biopsy confirmed eosinophilic vasculitis. Intracardiac mass resolved shortly after pulse steroids indicating an inflammatory mass.
一名35岁的沙特黑人男性,自幼患有支气管哮喘和过敏性鼻炎,现出现关节疼痛、肿胀、端坐呼吸、阵发性夜间呼吸困难和下肢水肿。检查时,我们发现颈静脉怒张、双侧肺底湿啰音、哮鸣音和弥漫性滑膜炎。检查结果显示外周血嗜酸性粒细胞增多、心包积液、超声心动图显示左心室流出道有细长结构、纵隔和肺门淋巴结肿大以及高分辨率CT扫描显示右上叶浸润。肺浸润活检证实为嗜酸性血管炎。心脏肿块在使用脉冲类固醇后不久消失,提示为炎性肿块。