以冠状动脉痉挛为首发表现的POEMS综合征1例

Coronary artery spasm as the initial manifestation of POEMS syndrome: one case report

本文报道1例少见的以反复冠状动脉(冠脉)痉挛为首发表现,后诊断为POEMS综合征的患者。该患者最初以上腹及胸痛,伴胸闷就诊心内科,冠脉造影未见确切冠脉狭窄,后出现多发周围神经病变、内分泌异常、单克隆球蛋白等,最终诊断为POEMS综合征。治疗POEMS综合征初期,患者仍有反复胸闷、胸痛发作,再次冠脉造影检查证实存在冠脉痉挛,治疗4周期后,患者POEMS综合征得到控制,胸闷胸痛未再发作。

This study reports a rare case of POEMS syndrome with recurrent coronary spasm. The patient had abdominal and chest pain accompanied by chest tightness for 24 hours and was admit to hospital, but coronary angiography showed no definite coronary stenosis. Then the patient suffered multiple peripheral neuropathy. Finally, he was diagnosed as POEMS syndrome. During the treatment of POEMS syndrome, the patient still had recurrent episodes of chest tightness and chest pain, then coronary artery spasm was confirmed by coronary angiography. After 4 cycles of treatment, the patient's POEMS syndrome remission, chest tightness and chest pain did not occur again.