Tazawa R, Saijo Y, Abe T, Satoh K, Watanabe A, Yamaki S, Nukiwa T
Department of Respiratory Oncology and Molecular Medicine, Tohoku University, Sendai, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Dec;35(12):1413-7.
A 51-year-old woman was referred to our hospital with dyspnea. Chest roentgenogram on admission showed dilation of the pulmonary arteries and hyperlucency in the lung fields. An ultrasonic cardiographic examination showed that the right atrium and ventricle were dilated. Pulmonary thromboembolism due to left popliteal vein thrombosis was diagnosed by perfusion scintigram of the lung, which showed multiple wedge-shaped defects, and by digital subtraction angiogram, which showed a filing defect in the left popliteal vein. Antiphospholipid syndrome was diagnosed after IgG anticardiolipin antibody was defected. Scleroderma was subsequently diagnosed because the patient exhibited Raynaud's phenomenon and proximal scleroderma. Although closely associated with lupus erythematosus and other lupus variants, antiphospholipid syndrome has not been recognized as a common complication of scleroderma. This is the first report of a patient with pulmonary thromboembolism associated with antiphospholipid syndrome and scleroderma.
一名51岁女性因呼吸困难转诊至我院。入院时胸部X线片显示肺动脉扩张，肺野透亮度增加。超声心动图检查显示右心房和右心室扩张。通过肺灌注闪烁扫描显示多个楔形缺损以及数字减影血管造影显示左腘静脉充盈缺损，诊断为左腘静脉血栓形成所致的肺血栓栓塞。检测到IgG抗心磷脂抗体后诊断为抗磷脂综合征。随后诊断为硬皮病，因为该患者出现雷诺现象和近端硬皮病。尽管抗磷脂综合征与红斑狼疮及其他狼疮变体密切相关，但尚未被认为是硬皮病的常见并发症。这是首例关于抗磷脂综合征和硬皮病相关肺血栓栓塞患者的报告。
