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儿童患肉芽肿性多血管炎致多发性巨大冠状动脉瘤

Multiple Giant Coronary Artery Aneurysms in a Pediatric Patient with Granulomatosis with Polyangiitis.

机构信息

Division of Cardiology, Phoenix Children's Hospital, Phoenix, USA.

The Heart Center, 1919 East Thomas Road, Phoenix, AZ, 85016, USA.

出版信息

Pediatr Cardiol. 2022 Aug;43(6):1392-1395. doi: 10.1007/s00246-022-02875-3. Epub 2022 Apr 9.

DOI:10.1007/s00246-022-02875-3
PMID:35396672
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8993586/
Abstract

Granulomatosis with polyangiitis (GPA) is characterized by necrotizing vasculitis of small and medium sized vessels and is rarely present in the pediatric population. Cardiac manifestations in pediatric patients with GPA are extremely uncommon, with only two known reported cases associated with coronary artery aneurysms (Rehani and Nelson in Pediatrics 147:e20200932, 2021, https://doi.org/10.1542/peds.2020-0932 ;Aghaei Moghadam et al. in Case Rep Cardiol 2020:3417910, 2020, https://doi.org/10.1155/2020/3417910 ). We report a case of a 14-year-old male who presented with a 1 month history of fatigue and shortness of breath. He ultimately was found to have multiple giant coronary aneurysms in both the left and right coronaries including a giant aneurysm in the posterior descending; this has not been previously reported. The case highlights the need for complete multi-modality imaging of the coronary arteries in patients with GPA.

摘要

肉芽肿性多血管炎（GPA）的特征为小及中等血管的坏死性血管炎，在儿科人群中罕见。GPA 儿科患者的心脏表现极为罕见，仅有两例已知病例与冠状动脉瘤相关（Rehani 和 Nelson 在 Pediatrics 147:e20200932, 2021, https://doi.org/10.1542/peds.2020-0932;Aghaei Moghadam 等人在 Case Rep Cardiol 2020:3417910, 2020, https://doi.org/10.1155/2020/3417910）。我们报告了 1 例 14 岁男性病例，他因疲劳和呼吸急促就诊，病史 1 个月。最终发现他的左右冠状动脉均存在多个巨大冠状动脉瘤，包括后降支中的巨大动脉瘤；这在此前的报道中尚未出现。该病例强调了 GPA 患者需要进行冠状动脉的多模态成像检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bb/8993586/5c83bc5d0e72/246_2022_2875_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bb/8993586/4e5c23264347/246_2022_2875_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bb/8993586/a5788edb98aa/246_2022_2875_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bb/8993586/42a9524bfd25/246_2022_2875_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bb/8993586/5c83bc5d0e72/246_2022_2875_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bb/8993586/4e5c23264347/246_2022_2875_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bb/8993586/a5788edb98aa/246_2022_2875_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bb/8993586/42a9524bfd25/246_2022_2875_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9bb/8993586/5c83bc5d0e72/246_2022_2875_Fig4_HTML.jpg

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