Nakazawa Naomi, Katsuki Toshiomi, Fujisawa Taishi, Nakajima Kazuaki, Kobayashi Ayumi, Kanki Hideaki, Koyama Takashi
Department of Cardiology, Saitama Municipal Hospital, Japan.
Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan.
Intern Med. 2025 May 1;64(9):1359-1364. doi: 10.2169/internalmedicine.3736-24. Epub 2024 Oct 11.
A 48-year-old woman with a history of bronchial asthma and allergic rhinitis presented with cardiac arrest due to ventricular fibrillation and was resuscitated by defibrillation. Coronary angiography revealed coronary vasospasm. Various antispastic agents were unable to control recurrent coronary spasms. We searched for other points of intervention and found a significant increase in the eosinophil count. The patient received mepolizumab for bronchial asthma with eosinophilia, which normalized the eosinophil count. Since then, the patient has remained free from coronary vasospasm, suggesting that mepolizumab may be a viable option for treating refractory coronary angina associated with bronchial asthma and eosinophilia.
一名有支气管哮喘和过敏性鼻炎病史的48岁女性因室颤导致心脏骤停,经除颤后复苏。冠状动脉造影显示冠状动脉痉挛。各种抗痉挛药物均无法控制复发性冠状动脉痉挛。我们寻找其他干预点,发现嗜酸性粒细胞计数显著增加。该患者因嗜酸性粒细胞增多的支气管哮喘接受了美泊利珠单抗治疗,嗜酸性粒细胞计数恢复正常。从那时起,患者未再出现冠状动脉痉挛,这表明美泊利珠单抗可能是治疗与支气管哮喘和嗜酸性粒细胞增多相关的难治性冠状动脉心绞痛的可行选择。