症例 Mycoplasma Pneumoniae肺炎に合併した心膜心筋炎の2例
Mycoplasma Pneumoniae感染はやく4年ごとに流行し,いくつかの合併症が報告されているが,心臓病変の合併はまれである.胸部X線上異型肺炎と診断され,心電図異常を認めた2例を経験し,臨床所見と経過を記載した.いずれも,急性肺感染症状に一致して,心電図異常,心不全,血圧低下を認めた.これらの症例は低蛋白血症, 低γ グロブリン血症を示し, 免疫機序の障害が示唆された. 症例1 において, 第6 2 病日に右室心筋生検を実施し,心筋配列異常・間質の線維化・核周囲の顆粒状物質の沈着・Pyknosisなどの心筋細胞の変性所見を得た. M.Pneumoniae感染症は予後がよいため,剖検例...
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| Published in | 心臓 Vol. 13; no. 2; pp. 231 - 237 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
公益財団法人 日本心臓財団
1981
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Mycoplasma Pneumoniae感染はやく4年ごとに流行し,いくつかの合併症が報告されているが,心臓病変の合併はまれである.胸部X線上異型肺炎と診断され,心電図異常を認めた2例を経験し,臨床所見と経過を記載した.いずれも,急性肺感染症状に一致して,心電図異常,心不全,血圧低下を認めた.これらの症例は低蛋白血症, 低γ グロブリン血症を示し, 免疫機序の障害が示唆された. 症例1 において, 第6 2 病日に右室心筋生検を実施し,心筋配列異常・間質の線維化・核周囲の顆粒状物質の沈着・Pyknosisなどの心筋細胞の変性所見を得た. M.Pneumoniae感染症は予後がよいため,剖検例は少なく,心筋炎の組織所見の特徴は明らかでない.組織所見についての文献的考察を行った. |
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| AbstractList | Mycoplasma Pneumoniae感染はやく4年ごとに流行し,いくつかの合併症が報告されているが,心臓病変の合併はまれである.胸部X線上異型肺炎と診断され,心電図異常を認めた2例を経験し,臨床所見と経過を記載した.いずれも,急性肺感染症状に一致して,心電図異常,心不全,血圧低下を認めた.これらの症例は低蛋白血症, 低γ グロブリン血症を示し, 免疫機序の障害が示唆された. 症例1 において, 第6 2 病日に右室心筋生検を実施し,心筋配列異常・間質の線維化・核周囲の顆粒状物質の沈着・Pyknosisなどの心筋細胞の変性所見を得た. M.Pneumoniae感染症は予後がよいため,剖検例は少なく,心筋炎の組織所見の特徴は明らかでない.組織所見についての文献的考察を行った. |
| Author | 中村, 嘉孝 |
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| Copyright | 公益財団法人 日本心臓財団 |
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| DOI | 10.11281/shinzo1969.13.2_231 |
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| References | 11) El Khatib, M. R. and Lerner, A. M.: Myocarditis in Mycoplasma pneumoniae pneumon i a. Occurrence with hemolytic anemia and extraordinary titers of cold isohemagglutinins. J. A. M. A., 231: 493, 1975. 15) Sands, M. J. Jr., Satz, J. E., Turner, W. E. Jr. and Soloff, L. A.: Pericarditis and perimyocarditis associated with active Mycoplasma pneumoniae infection. Ann. Intern. Med., 86: 544, 1977. 3) Lambert, H. P.: Infections caused by Mycoplasma pneumoniae. Brit. J. Dis. Chest, 6 3: 71, 1969. 16) Naftalin, J. M., Wellisch, G., Kahana, Z. and Diengott, D.: Mycoplasma pneumoniae s e pticemia. J. A. M. A., 228: 565, 1974. 9) Feizi, O., Grubb, C., Skinner, J. I., Constantinidou, M. and Henderson, W. G.: U nusual complications of primary atypical pneumonia due to M. pneumoniae. Br. Med. J., 4: 751, 1971. 6) Finkelstein, L. D. and Klainer, C. M. J.: Pericarditis associated with primary atypical pneumonia. Am. Heart J., 28: 385, 1944. 4) Painton, J. F., Hicks, A. M. and Hantman, S. H.: A clinical analysis of primary atypical pneumonia with a discussion of electrocardiographic findings. Ann. Intern. Med., 24: 775, 1946. 1) Eaton, M. D., Meiklejohn, G. and van Herick, W.: Studies on the etiology of primary typical pneumonia. J. Exp. Med., 79: 649, 1944. 7) Halpern, S. E. and Pugsley, W. S.: Pericarditis and hemorrhagic pleural effusion assoc iated with cold agglutinin positive pneumonia. J. O kla. State Med. Assoc., 62: 199, 1969. 2) Chanock, R. M., Mufson, M. A., James, W. D., Fox, H. H., Bloom, H. H. and Forsyth, B.: Rec overy of PPLO of atypical pnei. monia on artif i cial agar medium. Proc. Soc. Exp. Biol. Me d., 110: 543, 1962. 5) Grayston, J. T., Alexander, E. R., Kenny, G. E., Clarke, E. R., Fremont, J. C. and MacCol l, W. A.: Mycoplasma pneumoniae in f ections. Clinical and epidemiologic studies. J. A. M. A., 191: 97, 1965. 8) Gerzen, P., Granath, A.. Holmgren, B. and Zetterquist, S.: Acute myocarditis. A follow-u p study. Br. Heart J., 34: 575, 1972. 21) Smith, W. G.: Adult heart disease due to the coxsackie virus group B. Br. Heart J. 28: 204, 1966. 18) Meiklejohn, G., Eaton, M. D. and Herick, W.: A clinical report on cases of primary atypical pneumonia caused by a new virus. J. Clin. Invest., 24: 241, 1945. 20) Sekiguchi, M., Hiroe, M., Take, M. and Hirosawa, K.: Clinical and histopathological profile of sarcoidosis of the heart and acute idiopathic myocarditis. Concepts through a study employing endomyocardial biopsy. II Myocarditis. Jpn. Circul. J., 44: 264, 1980. 10) Lewes, D., Rainford, D. J. and Lane, W. F.: Symptomless myocarditis and myalgia in viral and Mycoplasma pneumoniae infections. Br. Heart J., 36: 924, 1974. 13) Nakamura, Y. and Akimoto, T.: A case of myocarditis due to Mycoplasma pneumoniae. Jpn. Circul. J., 41: 1313, 1977. 17) Meyers, B. R. and Hirschman, S. Z.: Fatal infections associated with Mycoplasma p n eumoniae. Discussion of three cases with necropsy findings. Mt. Sinai J. Med., 39: 258, 1972. 12) Yamane, Y. and Kawai, C.: A case of myocarditis caused by Mycoplasma pneumoniae. J p n. Circul. J., 42: 1279, 1978. 14) Maisel, J. C., Babbitt, L. H., and John, T. J.: Fatal Mycoplasma pneumoniae infection wit h isolation of organisms from lung. J. A. M. A., 202: 139, 1967. 19) Kitaura, Y. and Morita, H.: Secondary myocardi al disease. - Virus myocarditis and cardiomyopathy-. Jpn. Circul. J., 43: 1017, 1979. |
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| Title | 症例 Mycoplasma Pneumoniae肺炎に合併した心膜心筋炎の2例 |
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