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一例罕见的以胸痛为表现的心包结节病。

A rare case of pericardial sarcoidosis presenting as chest pain.

作者信息

El Sharu Husam, Jain Prarthana, Singer Bart, Snyder E Amanda

机构信息

Department of Internal Medicine East Carolina University Brody School of Medicine Greenville North Carolina USA.

Division of Rheumatology, Allergy & Immunology, Department of Medicine University of North Carolina Chapel Hill North Carolina USA.

出版信息

Clin Case Rep. 2024 Jul 14;12(7):e9160. doi: 10.1002/ccr3.9160. eCollection 2024 Jul.

DOI:10.1002/ccr3.9160
PMID:39011518
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11247156/
Abstract

KEY CLINICAL MESSAGE

Pericardial sarcoidosis is an uncommon cause of chest pain to consider, and it requires a heightened level of suspicion and thorough history gathering. If there is suspicion of inflammatory disease, pursuing advanced imaging and biopsies is crucial, as early immunosuppressive treatment can enhance outcomes.

ABSTRACT

Pericardial involvement in sarcoidosis is a rare condition with limited research. This case study discusses a 52-year-old African American woman who presented with subacute chest pain and was diagnosed with pericardial sarcoidosis. Diagnostic evaluation revealed extensive lymphadenopathy and pericardial effusion, and a pericardial biopsy confirmed non-caseating granulomatous inflammation. Treatment with steroids and methotrexate resulted in clinical improvement. Eight months follow-up showed near resolution of pericardial disease. This case emphasizes the importance of considering cardiac sarcoidosis in sarcoidosis patients, utilizing advanced imaging for accurate diagnosis, and tailoring treatment to the level of cardiac involvement.

摘要

关键临床信息

心包结节病是胸痛的一种罕见病因，需要高度怀疑并全面收集病史。如果怀疑有炎症性疾病，进行高级影像学检查和活检至关重要，因为早期免疫抑制治疗可改善预后。

摘要

结节病累及心包是一种罕见疾病，相关研究有限。本病例研究讨论了一名52岁非裔美国女性，她因亚急性胸痛就诊，被诊断为心包结节病。诊断评估显示广泛淋巴结肿大和心包积液，心包活检证实为非干酪样肉芽肿性炎症。使用类固醇和甲氨蝶呤治疗后临床症状改善。八个月的随访显示心包疾病几乎完全缓解。本病例强调了在结节病患者中考虑心脏结节病的重要性，利用高级影像学进行准确诊断，并根据心脏受累程度调整治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/946006a4ef5c/CCR3-12-e9160-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/ed46251248d6/CCR3-12-e9160-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/3cf615ce8ec7/CCR3-12-e9160-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/7411774ac8eb/CCR3-12-e9160-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/05bf3dc78192/CCR3-12-e9160-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/090f714a60dd/CCR3-12-e9160-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/946006a4ef5c/CCR3-12-e9160-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/ed46251248d6/CCR3-12-e9160-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/3cf615ce8ec7/CCR3-12-e9160-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/7411774ac8eb/CCR3-12-e9160-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/05bf3dc78192/CCR3-12-e9160-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/090f714a60dd/CCR3-12-e9160-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6c/11247156/946006a4ef5c/CCR3-12-e9160-g004.jpg

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