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白塞综合征患者并发心内膜炎、心内血栓及肺动脉瘤

Endocarditis, Intra-cardiac Thrombus, and Pulmonary Artery Aneurysm in a Patient with Behcet's Syndrome.

作者信息

Yildiz Fatih, Kelle Bayram, Erken Eren

机构信息

Division of Rheumatology, Department of Internal Medicine, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Türkiye.

Department of Physical Medicine and Rehabilitation, Cukurova University Faculty of Medicine, Adana, Türkiye.

出版信息

Sisli Etfal Hastan Tip Bul. 2024 Jun 28;58(2):244-248. doi: 10.14744/SEMB.2023.80000. eCollection 2024.

Abstract

Behçet's Syndrome (BS) is a chronic vasculitis of unknown etiology. Arterial involvement occurring in the pulmonary artery is associated with poor prognosis. It may cause pulmonary thrombus (PTE) and aneurysm (PAA) which may also lead to a rare complication, intracardiac thrombus. PAA and PTE can be complications of BS and are associated with high morbidity and mortality. A 30-year-old male patient had a fever of 38.4°C, recurrent oral-genital ulcers, shortness of breath, cough, and sputum. In this case report, medical history, clinical and laboratory examinations, radiography, echocardiography, and computer tomography imaging examinations were performed. PAA, PTE, intracardiac and left popliteal vein thrombosis, and infective endocarditis were present. The patient was diagnosed with BS according to the International Study Group criteria. Surgery was performed for intracardiac thrombus. Vegetation within the thrombus was demonstrated histopathologically. The patient's clinical condition and laboratory tests improved with intervention and medical treatments. The patient with BS, PAA, PTE, intracardiac thrombus, and infective endocarditis was successfully treated with pulmonary embolization, antibiotics, and systemic immunosuppression, despite its rarity, poor prognosis, and high morbidity and mortality rates.

摘要

白塞病(BS)是一种病因不明的慢性血管炎。肺动脉受累与预后不良相关。它可能导致肺血栓(PTE)和动脉瘤(PAA),这也可能导致一种罕见的并发症——心内血栓。PAA和PTE可能是白塞病的并发症,且与高发病率和死亡率相关。一名30岁男性患者出现38.4°C发热、复发性口腔生殖器溃疡、呼吸急促、咳嗽和咳痰。在本病例报告中,进行了病史、临床和实验室检查、放射学检查、超声心动图检查以及计算机断层扫描成像检查。发现存在PAA、PTE、心内和左腘静脉血栓形成以及感染性心内膜炎。根据国际研究组标准,该患者被诊断为白塞病。对心内血栓进行了手术治疗。组织病理学检查显示血栓内有赘生物。经过干预和药物治疗,患者的临床状况和实验室检查结果有所改善。尽管患有白塞病、PAA、PTE、心内血栓和感染性心内膜炎的情况罕见、预后不良且发病率和死亡率高,但通过肺栓塞、抗生素和全身免疫抑制治疗,该患者成功治愈。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd2e/11249990/d1b14b02cacb/SEMB-58-244-g001.jpg

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