- 期刊
The Valvular Involvement of Lupus: Congestive Heart Failure Can Be the Presenting Feature of Systemic Lupus Erythematosus
全身性紅斑性狼瘡可以以鬱血性心臟衰竭來表現
摘要
瓣膜性心臟病是紅斑性狼瘡最重要的心臟表現，然而因為紅斑性狼瘡造成需要開刀的嚴重二尖瓣閉鎖不全很少見。我們報告一個22歲的男性病患一開始是以鬱血性心衰竭的症狀表現，而最終是診斷為紅斑性狼瘡併二尖辦閉鎖不全。這個病人符合四個American College of Rheumatoloy的診斷準則包括漿膜炎，血液學異常，陽性抗核抗體(ANA:640X)，陽性雙螺旋脫氣核糖核酸(anti-dsDNA:640X)。這病人後來接受了二尖瓣手術且結果不錯。切除的二尖瓣病理學上的檢驗呈現退化性且發炎細胞浸潤的瓣膜，符合Libman-Sacks心內膜炎的診斷。這個病例提醒我們，紅斑性狼瘡（即使對男性病患）也是造成嚴重二尖瓣閉鎖不全的其中一個可能原因。
並列摘要
Valvular heart disease is the most important cardiac manifestation of systemic lupus erythematosus (SLE). However, severe mitral valve regurgitation necessitating valvular surgery due to SLE is rare. We report a 22-year-old male patient presenting with symptoms of congestive heart failure initially in whom lupus and severe mitral valve regurgitation were diagnosed. In our patient, four of the American College of Rheumatology diagnostic criteria for SLE were present, including serositis, hematological abnormalities, positive ANA (640X), and positive double-stranded DNA (640X). This patient eventually underwent mitral valve surgery with good clinical results. Pathological examination of the excised mitral valve leaflet showed degenerated valve with chronic inflammatory cell infiltration which was consistent with Libman-Sacks endocarditis. It serves as a reminder that SLE (even in a male patient) may be an underlying cause for the development of severe mitral valve regurgitation.
延伸閱讀
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