合并非典型Takotsubo心肌病的视神经脊髓炎谱系疾病一例

Atypical Takotsubo cardiomyopathy associated with neuromyelitis optica spectrum disorders:a case report

近年来,研究证据表明视神经脊髓炎谱系疾病(NMOSD)倾向于是多系统受累的自身免疫性疾病,但表现为心肌损伤的病例罕有报道。文中报道1例青年女性患者,临床表现为双侧视神经炎、延髓极后区综合征、脑干综合征和横贯性脊髓炎的经典核心症状,在病程中还出现了心率增快、心电图异常、心肌酶谱轻中度改变和B型钠尿肽明显升高以及左室基底段运动幅度减低等心肌损伤改变,符合NMOSD合并Takotsubo心肌病的诊断。应用大剂量糖皮质激素联合静脉注射丙种球蛋白治疗后,心肌损伤表现随着神经功能缺损症状的改善而快速恢复。这一罕见病例值得临床医生关注,其不仅拓宽了NMOSD的症状谱,还为NMOSD器官损害机制的进一步探索提供了新的思路。

Recently,neuromyelitis optica spectrum disorders(NMOSD)appear to be a multi-organ disorder,however,the involvement of myocardium in NMOSD is extremely rare.In the present article,we present a young girl who manifested bilateral optic neuritis,area postrema syndrome,brainstem syndrome and transverse myelitis,as well as tachycardia,abnormal electrocardiograph,moderate elevation of myocardial biomarker and regional wall movement abnormalities,which confirmed the diagnosis of Takotsubo cardiomyopathy associated with NMOSD.The neurological deficits along with myocardial injury were recovered soon after the administration of intravenous methylprednisolone and intravenous immunogloblin.This is a rare case that should be paid attention and by which can not only broaden the symptom spectrum of NMOSD,but can also provide novel visions for further investigating the mechanism of organs damage.