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抗中性粒细胞胞浆抗体相关血管炎中的加速动脉粥样硬化:病例报告

Accelerated atherosclerosis in Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: case report.

作者信息

Uribe Ruíz Natalia Andrea, Villa María Paulina, Gutiérrez Alberto Álzate, Saldarriaga Giraldo Clara Inés, Thorrens Ríos José Gregorio

机构信息

Universidad de Antioquia, Medellín, Colombia. Universidad de Antioquia Universidad de Antioquia Medellín Colombia.

Universidad Pontificia Bolivariana, Medellín, Colombia. Universidad Pontificia Bolivariana Universidad Pontificia Bolivariana Medellín Colombia.

出版信息

Arch Peru Cardiol Cir Cardiovasc. 2024 Mar 19;5(1):40-44. doi: 10.47487/apcyccv.v5i1.331. eCollection 2024 Jan-Mar.

DOI:10.47487/apcyccv.v5i1.331
PMID:38596604
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10999312/
Abstract

Accelerated atherosclerosis has been identified as a complication of multiple autoimmune diseases, among which Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis stands out. We describe the case of a 60-year-old patient with a history of hypertension, diabetes mellitus, and chronic kidney disease of unknown etiology, who presented two acute coronary syndromes with only a six-month difference. Rapid progression of coronary involvement was evidenced, along with increased markers of inflammatory response, usual interstitial pneumonia on tomography, and positive anti-myeloperoxidase antibodies (anti-MPO), leading to the diagnosis of microscopic polyangiitis (MPA). In these cases, timely diagnostic suspicion is crucial, as early treatment significantly impacts the course and prognosis of the disease.

摘要

加速性动脉粥样硬化已被确认为多种自身免疫性疾病的并发症,其中抗中性粒细胞胞浆抗体相关性血管炎最为突出。我们描述了一名60岁患者的病例,该患者有高血压、糖尿病和病因不明的慢性肾脏病病史,在仅6个月的时间内出现了两次急性冠状动脉综合征。冠状动脉受累进展迅速,同时炎症反应标志物升高,胸部断层扫描显示有寻常型间质性肺炎,抗髓过氧化物酶抗体(抗MPO)呈阳性,最终诊断为显微镜下多血管炎(MPA)。在这些病例中,及时的诊断怀疑至关重要,因为早期治疗会显著影响疾病的病程和预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92af/10999312/e962b65d3ab2/apcyccv-5-40-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92af/10999312/3ebb03dc244b/apcyccv-5-40-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92af/10999312/e962b65d3ab2/apcyccv-5-40-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92af/10999312/3ebb03dc244b/apcyccv-5-40-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92af/10999312/e962b65d3ab2/apcyccv-5-40-gf2.jpg

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本文引用的文献

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Cardiovascular disease and ANCA-associated vasculitis: are we missing a beat?心血管疾病与抗中性粒细胞胞浆抗体相关性血管炎:我们是否忽略了什么?
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Cardiovascular disease in patients with chronic inflammation: mechanisms underlying premature cardiovascular events in rheumatologic conditions.慢性炎症患者的心血管疾病:风湿性疾病中过早发生心血管事件的潜在机制。
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