Imawaka Motoaki, Tanaka Yudai, Mishiro Tsuyoshi, Sano Chiaki, Ohta Ryuichi
Family Medicine, Shimane University Medical School, Izumo, JPN.
Commnity Care, Unnan City Hospital, Unnan, JPN.
Cureus. 2023 Feb 12;15(2):e34905. doi: 10.7759/cureus.34905. eCollection 2023 Feb.
Heyde syndrome is a multisystem disorder characterized by the triad of aortic stenosis (AS), gastrointestinal bleeding, and acquired von Willebrand syndrome. Age-related degeneration is the most common cause of aortic stenosis and is frequently encountered in today's aging society. Approximately 20% of patients with severe aortic stenosis have Heyde syndrome. We encountered an older patient with primary thrombocytosis who was brought to a rural community hospital with bloody stools and was diagnosed with bleeding from an intestinal arteriovenous malformation. A final diagnosis of Heyde syndrome was made based on the presence of severe aortic stenosis and the presence of schistocytes in peripheral blood smears. Valvular diseases can complicate chronic hematological diseases. When the rapid progression of anemia and segmented red blood cells in the peripheral blood are observed in patients with severe aortic stenosis, Heyde syndrome should be considered based on peripheral blood smears and clinical course.
海德综合征是一种多系统疾病,其特征为三联征:主动脉瓣狭窄(AS)、胃肠道出血和获得性血管性血友病综合征。年龄相关性退变是主动脉瓣狭窄最常见的病因,在当今老龄化社会中屡见不鲜。约20%的重度主动脉瓣狭窄患者患有海德综合征。我们遇到一名老年原发性血小板增多症患者,因便血被送至一家乡村社区医院,诊断为肠道动静脉畸形出血。基于存在重度主动脉瓣狭窄以及外周血涂片中有裂细胞,最终诊断为海德综合征。瓣膜疾病会使慢性血液系统疾病复杂化。当重度主动脉瓣狭窄患者出现贫血快速进展以及外周血中出现分叶红细胞时,应根据外周血涂片和临床病程考虑海德综合征。