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肺部复杂感染合并血管性埃勒斯-当洛综合征:一例报告。

Pulmonary complex infection with vascular Ehlers-Danlos syndrome: A case report.

作者信息

Okamura Ken, Noro Rintaro, Tanaka Toru, Kashiwada Takeru, Tanaka Yosuke, Saito Yoshinobu, Fujita Kazue, Akutsu Koichi, Sahara Tomoko, Kamio Koichiro, Yamada Takeshi, Kasahara Kazuo, Seike Masahiro

机构信息

Department of Respiratory Medicine, Nippon Medical School Hospital, Tokyo, Japan.

Department of Cardiology, Nippon Medical School Hospital, Tokyo, Japan.

出版信息

Respir Med Case Rep. 2024 Sep 16;52:102119. doi: 10.1016/j.rmcr.2024.102119. eCollection 2024.

Abstract

A female patient developed multiple intestinal perforations at 31 and 43 years of age. Because of her family history of pneumothorax and intestinal perforation, Ehlers-Danlos syndrome (EDS) was suspected when she visited our hospital at 52 years. She was diagnosed with vascular Ehlers-Danlos syndrome (vEDS) and developed bilateral external iliac artery dissection. A CT scan at the time of admission revealed granular and infiltrative shadows in both lungs with bronchiectasis. The patient was also diagnosed with complex (MAC) pulmonary disease, and drug susceptibility to clarithromycin was confirmed. After treatments with rifampicin, ethambutol, and clarithromycin were started, the acid-fast bacilli cultures taken from sputum were negative, and respiratory symptoms partially improved after about 1 month. vEDS is reportedly associated with lung diseases, such as pneumothorax and cystic lung lesions, but there are few reports of respiratory infections with vEDS. Moreover, there are no reports of complications associated with MAC disease. We report a case of vEDS with rare complications and suggest the possible mechanism of infection.

摘要

一名女性患者在31岁和43岁时出现多处肠道穿孔。由于她有气胸和肠道穿孔的家族史,52岁就诊于我院时怀疑患有埃勒斯-当洛综合征(EDS)。她被诊断为血管型埃勒斯-当洛综合征(vEDS),并发生双侧髂外动脉夹层。入院时的CT扫描显示双肺有颗粒状和浸润性阴影伴支气管扩张。该患者还被诊断为复杂性(MAC)肺部疾病,并证实对克拉霉素药物敏感。在用利福平、乙胺丁醇和克拉霉素治疗开始后,痰中结核分枝杆菌培养结果为阴性,约1个月后呼吸道症状部分改善。据报道,vEDS与肺部疾病有关,如气胸和肺囊性病变,但关于vEDS合并呼吸道感染的报道很少。此外,尚无与MAC疾病相关并发症的报道。我们报告一例罕见并发症的vEDS病例,并提出可能的感染机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/977a/11440296/e432e69b46bd/gr1.jpg

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