Ma Huihui, Cao Xin, Zhang Jing, Zhou Yongmei, Luo Rong, He Tao, Tao Jianhong, Li Xiaoping
Department of Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan 610072, China.
Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu 610072, China.
Case Rep Cardiol. 2021 Apr 11;2021:6633085. doi: 10.1155/2021/6633085. eCollection 2021.
A 32-year-old female with systemic lupus erythematosus (SLE) for more than 7 years, and long-term treatment with cyclophosphamide, cyclosporine, methotrexate, and tacrolimus, later found to be combined with hypertrophic cardiomyopathy (HCM) for one year. The patient denied a family history of cardiomyopathy and sudden cardiac death (SCD). Echocardiography suggested that uneven thickening of the left ventricle (LV), mainly in the lower middle segment. Cardiac magnetic resonance (CMR) showed that the walls of the left ventricular (LV) were significantly thickened, as about 21 mm, mainly in the middle and lower segments. Genetic tests showed no known or suspected pathogenic variations were found and no significant enhancement in CMR, so secondary HCM was diagnosed clinically. After symptomatic treatment, the patient was discharged, and long-term follow-up was conducted. The diagnosis of HCM, which combined with SLE or second to usage of tacrolimus, was based on symptoms, echocardiography, and CMR; no endomyocardial biopsies were performed.
一名32岁女性，患系统性红斑狼疮（SLE）7年多，长期使用环磷酰胺、环孢素、甲氨蝶呤和他克莫司治疗，后来发现合并肥厚型心肌病（HCM）1年。患者否认有心肌病家族史和心源性猝死（SCD）家族史。超声心动图提示左心室（LV）不均匀增厚，主要位于中下段。心脏磁共振成像（CMR）显示左心室（LV）壁明显增厚，约21毫米，主要位于中下段。基因检测未发现已知或疑似致病变异，CMR也无明显强化，因此临床诊断为继发性HCM。经对症治疗后，患者出院，并进行长期随访。HCM合并SLE或继发于他克莫司使用的诊断基于症状、超声心动图和CMR；未进行心内膜心肌活检。
