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休斯-斯托文综合征,一种表现为复发性心内血栓的罕见白塞病形式。

Hughes Stovin Syndrome, a Rare Form of Behcet's Disease Presenting as Recurrent Intracardiac Thrombus.

作者信息

B K Anupama, Tymko Casey, Subedi Rogin, Virk Jaswinder, Chaudhuri Debanik

机构信息

Internal Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

Anesthesiology, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

出版信息

Cureus. 2020 May 1;12(5):e7907. doi: 10.7759/cureus.7907.

Abstract

Hughes Stovin syndrome (HSS) is a particularly rare disease characterized by multiple pulmonary artery and/or bronchial artery aneurysms with concomitant peripheral venous thrombosis and is believed to be a cardiovascular variant of Behcet's disease. Intracardiac thrombus occurring as a thrombotic manifestation of HSS is an unusual presentation and represents a challenge in diagnosis and treatment. Here we report a 25-year-old male presenting with recurrent right-sided intracardiac thrombi, in whom pulmonary artery aneurysm was later detected in the clinical course corroborating the diagnosis of HSS and leading to appropriate initiation of immunosuppressive agents. The patient required multiple cardiac surgeries during the clinical course for cardiovascular complications associated with recurrent cardiac thrombus. Unfortunately, the patient was readmitted a year later for massive hemoptysis secondary to pulmonary arterial aneurysm rupture requiring left lower lobectomy. Our case highlights also the significant morbidity, complications, and treatment challenges associated with this potentially life-threatening syndrome, which is intensified in the presence of cardiac involvement.

摘要

休斯-斯托文综合征(HSS)是一种极为罕见的疾病,其特征为多发性肺动脉和/或支气管动脉动脉瘤,并伴有外周静脉血栓形成,被认为是白塞病的一种心血管变异型。作为HSS血栓形成表现的心脏内血栓是一种不寻常的表现,对诊断和治疗构成挑战。在此,我们报告一名25岁男性,反复出现右侧心脏内血栓,在临床过程中后来检测到肺动脉瘤,这证实了HSS的诊断,并促使适当启动免疫抑制剂。在临床过程中,患者因与复发性心脏血栓相关的心血管并发症接受了多次心脏手术。不幸的是,患者在一年后因肺动脉瘤破裂继发大量咯血而再次入院,需要进行左下肺叶切除术。我们的病例还凸显了这种潜在危及生命的综合征所带来的显著发病率、并发症和治疗挑战,在存在心脏受累的情况下这些情况会加剧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f058/7263413/7399df56a1ff/cureus-0012-00000007907-i01.jpg

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