以孤立性冠状动脉血管炎形式表现的嗜酸性肉芽肿性多血管炎
Eosinophilic Granulomatosis With Polyangiitis Presenting as Isolated Coronary Vasculitis.
作者信息
Lateef Azalfa, Grennan Krista, Tayon Kevin, Laenger Jessica, Seby Robert, Mumtaz Sehreen, Cortopassi Isabel, Majithia Vikas, Cooper Leslie, Bravo-Jaimes Katia
机构信息
Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA.
Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA.
出版信息
JACC Case Rep. 2025 Jul 30;30(21):104412. doi: 10.1016/j.jaccas.2025.104412.
BACKGROUND
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis that can have cardiac involvement. Isolated coronary vasculitis as the sole EGPA manifestation is rare.
CASE SUMMARY
A 30-year-old man with asthma and rhinitis presented with recurrent chest pain from coronary vasospasm due to EGPA. Treatment included cyclophosphamide, prednisone, verapamil, and nitrates. At the 6-month follow-up, he was asymptomatic.
DISCUSSION
Coronary vasospasm secondary to EGPA can be present in younger populations and will present with acute coronary syndrome. EGPA flares can be triggered by viral infections.
TAKE-HOME MESSAGES: EGPA vasculitis can present with coronary vasospasm as the sole presenting symptom in young patients. EGPA vasculitis should be considered in patients with elevated eosinophils who have recurrent acute coronary syndrome with coronary vasospasm, especially in those with vasospasm refractory to typical medical management and with known/suspected EGPA.
背景
嗜酸性肉芽肿性多血管炎（EGPA）是一种可累及心脏的系统性血管炎。孤立性冠状动脉血管炎作为EGPA的唯一表现较为罕见。
病例摘要
一名患有哮喘和鼻炎的30岁男性因EGPA导致冠状动脉痉挛而反复出现胸痛。治疗包括环磷酰胺、泼尼松、维拉帕米和硝酸盐。在6个月的随访中，他无症状。
讨论
EGPA继发的冠状动脉痉挛可出现在年轻人群中，并会表现为急性冠状动脉综合征。EGPA发作可由病毒感染触发。
要点
EGPA血管炎可在年轻患者中以冠状动脉痉挛作为唯一的首发症状出现。对于嗜酸性粒细胞增多且反复出现伴有冠状动脉痉挛的急性冠状动脉综合征的患者，尤其是那些对典型药物治疗难治的痉挛患者以及已知/疑似EGPA的患者，应考虑EGPA血管炎。
Zotero 插件