心不全を呈し, 心筋シンチで心筋障害を証明しえた強皮症の1例  [in Japanese] A case of scleroderma with congestive heart failure of which myocardial injury was detected by Scintigraphy  [in Japanese]

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Abstract

症例は38歳の女性. 15年前にレイノー症状を初発とし強皮症と診断され,冬期には指尖潰瘍を繰り返していた.平成13年6月,労作時息切れの増悪を認め,当科入院となった.入院時の胸部X線ではCTR 65%と心陰影拡大,両側胸水を認めた.心エコー検査では左室の壁運動のび漫性の低下および左室駆出率の低下を認めた. T1心筋シンチにて左室全体に斑状の低集積が検出された.強皮症に伴う微小循環障害による心筋線維化が原因で心不全を呈したものと考え,利尿剤・強心剤とともにβ-blockerの漸増投与を行い,心機能の改善を認めた.心筋シンチは強皮症の心病変の検出に有用であり,検査陽性例では発症後はもとより発症前に薬物療法を開始することも重要と考えられた.

A 38-year-old woman with systemic sclerosis was admitted to our hospital because of dyspnea and finger ulcer. Chest X-p showed cardiomegaly and pleural effusion. Echocardiogram revealed diffuse hypokinesis of the left ventricle (ejection fraction 32%). Thallium scintigraphy demonstrated patchy perfusion defects. She was diagnosed as having congestive heart failure due to myocardial fibrosis, and was treated successfully with diuretics, cardiotonics, and β-blocker. Scintigraphy maybe useful to detect an early cardiac involvement in patients with systemic sclerosis, and intense pharmacological treatment might be started even before the patient develops symptoms.

Journal

  • Japanese Journal of Clinical Immunology

    Japanese Journal of Clinical Immunology 26(3), 121-126, 2003-06-30

    The Japan Society for Clinical Immunology

References:  10

Codes

  • NII Article ID (NAID)
    130000849567
  • NII NACSIS-CAT ID (NCID)
    AN00357971
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    09114300
  • Data Source
    CJP  J-STAGE 
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