传染性内心炎呈现为ANCA相关的质:一个复杂的诊断挑战
Claudia Galilea Cortes Flores1, Javier Jonse Gárate Togo1, Ma Virgilia Soto Abraham2
1Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
概括
传染性内心炎模仿ANCA相关的血管炎在一个患有心脏起器的患者. 及时诊断和治疗心脏起器感染解决了损伤和皮肤病变.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
背景情况:
- 一名59岁的妇女出现紫色病变,胀和急性损伤.
- 最初的评估表明,ANCA相关的血管炎是由于溶血性贫血,血栓缩和ANCA阳性.
研究的目的:
- 为了突出感染性内心炎和ANCA相关的血管炎之间的临床重叠.
- 强调感染查在患有快速进展的淋巴结膜炎和ANCA阳性的患者的重要性.
主要方法:
- 临床表现审查.
- 实验室和成像研究.
- 脏活检分析.
- 对治疗反应的评估.
主要成果:
- 一位患者最初因血管炎而接受皮质类固醇和环胺的治疗.
- 发烧和脏梗塞显示出Enterococcus faecalis菌病和心脏起器植被 (传染性内心炎).
- 脏活检显示,新月状丸炎与ANCA介导和免疫复合体特征.
- 移除硬件和抗生素可以消除感染,改善功能,并清除病变.
结论:
- 传染性内心炎可能与ANCA相关的血管炎类似.
- 应考虑心脏起器感染在患有淋巴结膜炎和ANCA阳性的患者.
- 多学科管理对于涉及心脏器械和自身免疫现象的复杂病例至关重要.
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