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感染性心内膜炎最初表现为假性痛风。

Infective endocarditis initially manifesting as pseudogout.

作者信息

Brotherton Tim, Miller Chad S

机构信息

Department of Medicine, Saint Louis University, St. Louis, Missouri.

School of Medicine, Saint Louis University, St. Louis, Missouri.

出版信息

Proc (Bayl Univ Med Cent). 2021 Mar 9;34(4):496-497. doi: 10.1080/08998280.2021.1888632.

Abstract

Infective endocarditis is a commonly encountered disease in which diagnosis is often challenging due to the variety of clinical manifestations. Early identification is key due to risk of mortality without treatment. In this case, a 31-year-old man presented with pseudogout of the right ankle and COVID-19 infection. Further workup showed blood cultures growing , and the diagnosis of infective endocarditis was confirmed by echocardiography. Independently, pseudogout and infective endocarditis result in activation of the innate immune system and can manifest with joint inflammation. Their co-occurrence likely resulted in an augmented inflammatory response due to overlap in their pathophysiologic pathways.

摘要

感染性心内膜炎是一种常见疾病,由于临床表现多样,其诊断往往具有挑战性。由于未经治疗会有死亡风险,早期识别至关重要。在本病例中,一名31岁男性出现右踝关节假性痛风和新型冠状病毒肺炎感染。进一步检查显示血培养有细菌生长,超声心动图证实了感染性心内膜炎的诊断。假性痛风和感染性心内膜炎各自都会激活先天性免疫系统,并可能表现为关节炎症。它们同时出现可能由于病理生理途径重叠而导致炎症反应增强。

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本文引用的文献

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COVID-19 revisiting inflammatory pathways of arthritis.COVID-19 再次审视关节炎的炎症通路。
Nat Rev Rheumatol. 2020 Aug;16(8):465-470. doi: 10.1038/s41584-020-0451-z. Epub 2020 Jun 19.
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Clinical Characteristics of Coronavirus Disease 2019 in China.《中国 2019 年冠状病毒病临床特征》
N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28.
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Calcium Pyrophosphate Deposition Disease.焦磷酸钙沉积病
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Gout-associated uric acid crystals activate the NALP3 inflammasome.痛风相关的尿酸晶体激活NALP3炎性小体。
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