脳塞栓で発症したLöffler心内膜炎の1例
24歳，男性．左側視野欠損を主訴に受診した．左同名半盲，収縮期雑音，好酸球増加及び頭部単純MRI（magnetic resonance imaging）で右後頭葉梗塞を認めた．経胸壁心エコー図では，左室下後壁基部～中部及び右室に壁在血栓を認めた．Löffler症候群及び慢性好酸球性白血病と診断し，イマチニブとプレドニゾロンで治療した．1カ月後に疣腫の消失及び左室機能の悪化がないことを確認した．心エコー検査は，Löffler症候群の診断及び経時的左室機能の観察に有用であった．...
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| Published in | 日本内科学会雑誌 Vol. 107; no. 8; pp. 1528 - 1536 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
10.08.2018
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.107.1528 |
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| Abstract | 24歳，男性．左側視野欠損を主訴に受診した．左同名半盲，収縮期雑音，好酸球増加及び頭部単純MRI（magnetic resonance imaging）で右後頭葉梗塞を認めた．経胸壁心エコー図では，左室下後壁基部～中部及び右室に壁在血栓を認めた．Löffler症候群及び慢性好酸球性白血病と診断し，イマチニブとプレドニゾロンで治療した．1カ月後に疣腫の消失及び左室機能の悪化がないことを確認した．心エコー検査は，Löffler症候群の診断及び経時的左室機能の観察に有用であった． |
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| AbstractList | 24歳，男性．左側視野欠損を主訴に受診した．左同名半盲，収縮期雑音，好酸球増加及び頭部単純MRI（magnetic resonance imaging）で右後頭葉梗塞を認めた．経胸壁心エコー図では，左室下後壁基部～中部及び右室に壁在血栓を認めた．Löffler症候群及び慢性好酸球性白血病と診断し，イマチニブとプレドニゾロンで治療した．1カ月後に疣腫の消失及び左室機能の悪化がないことを確認した．心エコー検査は，Löffler症候群の診断及び経時的左室機能の観察に有用であった． |
| Author | 増岡, 和宏 赤川, 由里 永井, 知雄 清塚, 鉄人 田畑, 博嗣 花城, 里依 新居田, 登三治 牧, もとみ 太田, 光 滝口, 俊一 |
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| DOI | 10.2169/naika.107.1528 |
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| References | 5) Lofiego C, et al: Ventricular remodeling in Loeffler endocarditis: implications for therapeutic decision making. Eur J Heart Fail 7: 1023-1026, 2005. 10) Haugland JM, et al: Embolic potential of left ventricular thrombi detected by two-dimensional echocardiography. Circulation 70: 588-598, 1984. 3) Valent P, et al: Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes. J Allergy Clin Immunol 130: 607-612, 2012. 6) Jin X, et al: Cardiac involvements in hypereosinophilia-associated syndrome: case reports and a little review of the literature. Echocardiography 34: 1242-1246, 2017. 1) Ogbogu PU, et al: Cardiovascular manifestations of hypereosinophilic syndromes. Immunol Allergy Clin North Am 27: 457-475, 2007. 8) Rotoli B, et al: Rapid reversion of Loeffler's endocarditis by imatinib in early stage clonal hypereosinophilic syndrome. Leuk Lymphoma 45: 2503-2507, 2004. 4) Swerdlow SH, et al: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition). IARC, Lyon, 2017. 9) Pardanani A, et al: Imatinib therapy for hypereosinophilic syndrome and other eosinophilic disorders. Blood 101: 3391-3397, 2003. 2) Mankad R, et al: Hypereosinophilic syndrome: cardiac diagnosis and management. Heart 102: 100-106, 2016. 7) Klion AD: How I treat hypereosinophilic syndromes. Blood 126: 1069-1077, 2015. |
| References_xml | – reference: 2) Mankad R, et al: Hypereosinophilic syndrome: cardiac diagnosis and management. Heart 102: 100-106, 2016. – reference: 8) Rotoli B, et al: Rapid reversion of Loeffler's endocarditis by imatinib in early stage clonal hypereosinophilic syndrome. Leuk Lymphoma 45: 2503-2507, 2004. – reference: 7) Klion AD: How I treat hypereosinophilic syndromes. Blood 126: 1069-1077, 2015. – reference: 9) Pardanani A, et al: Imatinib therapy for hypereosinophilic syndrome and other eosinophilic disorders. Blood 101: 3391-3397, 2003. – reference: 4) Swerdlow SH, et al: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition). IARC, Lyon, 2017. – reference: 6) Jin X, et al: Cardiac involvements in hypereosinophilia-associated syndrome: case reports and a little review of the literature. Echocardiography 34: 1242-1246, 2017. – reference: 10) Haugland JM, et al: Embolic potential of left ventricular thrombi detected by two-dimensional echocardiography. Circulation 70: 588-598, 1984. – reference: 3) Valent P, et al: Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes. J Allergy Clin Immunol 130: 607-612, 2012. – reference: 5) Lofiego C, et al: Ventricular remodeling in Loeffler endocarditis: implications for therapeutic decision making. Eur J Heart Fail 7: 1023-1026, 2005. – reference: 1) Ogbogu PU, et al: Cardiovascular manifestations of hypereosinophilic syndromes. Immunol Allergy Clin North Am 27: 457-475, 2007. |
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| SubjectTerms | FIP1L1-PDGFRA融合遺伝子 Löffler心内膜炎 イマチニブ 心原性脳塞栓 慢性好酸球性白血病 |
| Title | 脳塞栓で発症したLöffler心内膜炎の1例 |
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