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一位患有心脏结节病的患者,停止口服皮质类固醇治疗 3.5 年后,氟-18 氟脱氧葡萄糖的心肌摄取异常,并再次出现持续性室性心动过速。

A Patient with Cardiac Sarcoidosis in Whom an Abnormal Myocardial Uptake of Fluorine-18 Fluorodeoxyglucose and Sustained Ventricular Tachycardia Recurred 3.5 Years after Discontinuing Oral Corticosteroid Therapy.

机构信息

Department of Cardiology, Osaka Medical College, Japan.

Medical Education Center, Osaka Medical College, Japan.

出版信息

Intern Med. 2020 Sep 15;59(18):2275-2280. doi: 10.2169/internalmedicine.4524-20. Epub 2020 Jun 15.

Abstract

We herein report a woman diagnosed with cardiac sarcoidosis (CS) based on the presence of epithelioid granulomas in non-cardiac organs and clinical findings including sustained ventricular tachycardia (VT) and cardiac dysfunction. She stopped oral corticosteroid after 4 years of treatment, and an abnormal myocardial uptake of fluorine-18 fluorodeoxyglucose and sustained VT recurred 3.5 years later. There is no consensus concerning whether or not corticosteroid therapy should be discontinued in the treatment of CS. As a relapse of sarcoidosis-related inflammation may be associated with life-threatening arrhythmia, some patients should continue corticosteroid therapy, even at low doses.

摘要

我们在此报告一例女性心脏结节病(CS)患者,其依据是非心脏器官存在上皮样肉芽肿和临床发现,包括持续性室性心动过速(VT)和心功能障碍。她在治疗 4 年后停止口服皮质类固醇,3.5 年后再次出现氟-18 氟脱氧葡萄糖摄取异常和持续性 VT。关于 CS 的治疗是否应停止皮质类固醇治疗,尚无共识。由于结节病相关炎症的复发可能与危及生命的心律失常有关,因此一些患者即使低剂量也应继续皮质类固醇治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af7e/7578617/f48f31272b52/1349-7235-59-2275-g001.jpg

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