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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.

DOI:10.1136/bcr-2025-265654
PMID:40588302
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12210346/
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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本文引用的文献

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Repeated prosthetic heart valve thrombosis with idiopathic eosinophilia.反复发生的人工心脏瓣膜血栓形成伴特发性嗜酸性粒细胞增多症。
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A Unique Case of Cardiac Hypereosinophilia With Recurrent Valve Thrombosis After Mechanical Mitral Valve Replacement in the Setting of a Supratherapeutic International Normalized Ratio.一例独特的心脏嗜酸性粒细胞增多症病例,在国际标准化比值超治疗范围的情况下,二尖瓣机械置换术后出现复发性瓣膜血栓形成。
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嗜酸性粒细胞增多继发复发性人工心脏瓣膜血栓形成:漏诊病例
BMJ Case Rep. 2017 Oct 3;2017:bcr-2017-221313. doi: 10.1136/bcr-2017-221313.
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Eosinophilia and thrombosis in parasitic diseases: an overview.寄生虫病中的嗜酸性粒细胞增多与血栓形成:概述。
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Obstructive prosthetic mitral valve thrombosis in idiopathic hypereosinophilic syndrome: a case report and review of the literature.特发性嗜酸性粒细胞增多综合征合并梗阻性人工二尖瓣血栓形成:一例报告并文献复习
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