Szczerba Ewa, Kowalik Robert, Gorska Katarzyna, Mierzejewski Michal, Slowikowska Anna, Bednarczyk Tomasz, Marchel Michal, Krenke Rafal, Opolski Grzegorz
First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Department of Cardiology, Institute of Mother and Child, Warsaw, Poland.
Echocardiography. 2018 Dec;35(12):2099-2103. doi: 10.1111/echo.14171. Epub 2018 Oct 18.
We present a case of 44-year-old woman who underwent effective pharmacological treatment of severe mitral stenosis. The patient was hospitalized due to rapidly progressive dyspnea. Her medical history included asthma, perennial rhinitis, and nasal polyps. Echocardiography showed a mass of the left ventricle involving the mitral valve; cardiac MRI suggested acute endocarditis. Severe peripheral blood eosinophilia was found. Eosinophilic granulomatosis with polyangiitis was diagnosed; treatment with prednisone and cyclophosphamide was started. Despite the clinical improvement, severe mitral stenosis persisted, surgical treatment was planned. However, evaluation after 6 cycles of cyclophosphamide pulse therapy revealed a significant regression of the valvular disease.
我们报告一例44岁女性，其接受了重度二尖瓣狭窄的有效药物治疗。该患者因迅速进展的呼吸困难入院。她的病史包括哮喘、常年性鼻炎和鼻息肉。超声心动图显示左心室有一肿块累及二尖瓣；心脏磁共振成像提示急性心内膜炎。发现严重的外周血嗜酸性粒细胞增多。诊断为嗜酸性肉芽肿性多血管炎；开始使用泼尼松和环磷酰胺治疗。尽管临床症状有所改善，但重度二尖瓣狭窄仍然存在，遂计划进行手术治疗。然而，在环磷酰胺脉冲治疗6个周期后评估发现瓣膜疾病有显著消退。
