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寄生虫感染继发嗜酸性粒细胞增多所致人工二尖瓣复发性血栓形成的成功管理。

Successful management of recurrent thrombosis of prosthetic mitral valve induced by eosinophilia secondary to parasitic infection.

作者信息

Nguyen Thi Minh Ly, Nguyen Hieu Lan, Nguyen Lan Viet L, Pham Ngoc Minh N, Dang Hoang, Nguyen Lan Anh, Nguyen Hoa L, Goldberg Robert J

机构信息

Cardiology, Hanoi Medical University, Hanoi, Viet Nam

Cardiovascular Center, Hanoi Medical University Hospital, Hanoi, Viet Nam.

出版信息

BMJ Case Rep. 2025 Jun 30;18(6):e265654. doi: 10.1136/bcr-2025-265654.

Abstract

Acute prosthetic heart valve thrombosis (PHVT) is a severe complication affecting patients who have undergone heart valve replacement surgery. We present a case of acute recurrent PHVT associated with parasite-induced eosinophilia. A man in his early 50s with rheumatic heart disease underwent mechanical mitral valve replacement 5 years ago and received well-managed anticoagulation with regular follow-up visits. The patient developed a sudden onset of dyspnoea and was diagnosed with mechanical valve thrombosis, which was managed with thrombolysis. However, the valve became stuck again just a week after the initial episode while the patient was still in the hospital and was receiving anticoagulation within the target range. Concurrently, he experienced skin rashes and itching, prompting an investigation that revealed hypereosinophilia secondary to parasite infestation. The patient's valve functions well after thrombolysis and parasite infection treatment. The eosinophil counts were monitored to remain within the normal range.

摘要

急性人工心脏瓣膜血栓形成(PHVT)是心脏瓣膜置换手术后患者面临的一种严重并发症。我们报告一例与寄生虫诱导的嗜酸性粒细胞增多相关的急性复发性PHVT病例。一名50岁出头患有风湿性心脏病的男性在5年前接受了机械二尖瓣置换术,并接受了管理良好的抗凝治疗且定期复诊。患者突然出现呼吸困难,被诊断为机械瓣膜血栓形成,接受了溶栓治疗。然而,在初次发作仅一周后,患者仍住院且抗凝处于目标范围内时,瓣膜再次卡住。同时,他出现皮疹和瘙痒,促使进行的一项检查发现继发于寄生虫感染的嗜酸性粒细胞增多。患者在溶栓和寄生虫感染治疗后瓣膜功能良好。监测嗜酸性粒细胞计数以使其保持在正常范围内。

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