シガ ツヨシ   Tsuyoshi Shiga
  志賀 剛
   所属   医学部 医学科(東京女子医科大学病院)
   職種   客員教授
論文種別 症例報告
言語種別 英語
査読の有無 査読あり
表題 Successfully treated eosinophilic granulomatosis with polyangiitis relapse presenting as myocarditis and followed by multimodality imaging.
掲載誌名 正式名:Journal of cardiology cases
略  称:J Cardiol Cases
ISSNコード:1878-5409
掲載区分国内
出版社 Published by Elsevier B. V. on behalf of the Japanese College of Cardiology
巻・号・頁 18(4),145-148頁
著者・共著者 MIYAZAKI Midori†, HATTORI Hidetoshi*, SUZUKI Atsushi, SERIZAWA Naoki, UTO Kenta, FUKUSHIMA Kenji, MOMOSE Mitsuru, SHIGA Tsuyoshi, HAGIWARA Nobuhisa
発行年月 2018/10
概要 A 60-year-old man with eosinophilic granulomatosis with polyangiitis (EGPA), which was diagnosed 12 years earlier and managed with prednisolone, was admitted to our hospital because of dyspnea and paresthesias in both hands. Laboratory test revealed peripheral eosinophilia along with elevated troponin T and brain natriuretic peptide (BNP). The patient's clinical picture was consistent with myocarditis and relapse of EGPA. Endomyocardial biopsy showed marked infiltration of eosinophils in myocardium, which confirmed relapse of EGPA with myocarditis. Thallium-201 and iodine-123-beta-methyl iodophenyl pentadecanoic acid dual single-photon emission computed tomography (TL-BMIPP SPECT), as well as cardiac magnetic resonance imaging (CMR), also confirmed cardiac involvement. The patient was treated with methylprednisolone and improved dramatically. CMR and TL-BMIPP SPECT performed after discharge showed improvement of abnormal lesions, while anomalies detected by these modalities remained. This is a case of EGPA relapse presenting as myocarditis despite treatment with prednisolone. <Learning objective: Cardiac involvement and relapse are frequent in eosinophilic granulomatosis with polyangiitis patients. Patients should be screened and monitored carefully for cardiac involvement during follow-up by multimodality imaging.>.
DOI 10.1016/j.jccase.2018.06.008
PMID 30279934