IgG4相关性疾病(IgG4 related disease,IgG4-RD)是一种累及多器官、多系统的自身免疫性疾病。病变累及心包时表现为IgG4相关性心包炎。IgG4-RD临床表现无特异性,尤其对于基础疾病多的老年人,容易漏诊和误诊。本文报道1例老年IgG4相关性...IgG4相关性疾病(IgG4 related disease,IgG4-RD)是一种累及多器官、多系统的自身免疫性疾病。病变累及心包时表现为IgG4相关性心包炎。IgG4-RD临床表现无特异性,尤其对于基础疾病多的老年人,容易漏诊和误诊。本文报道1例老年IgG4相关性心包炎病例,结合文献复习并阐述其诊疗过程,以期提高临床对IgG4相关性心包炎的认识。展开更多
Acute pericarditis is usually a self-limiting disorder that commonly occurs due to viral etiology or unexplained causes.Meningococcal pericarditis(MP)is a remarkably uncommon clinical entity that manifests as a compli...Acute pericarditis is usually a self-limiting disorder that commonly occurs due to viral etiology or unexplained causes.Meningococcal pericarditis(MP)is a remarkably uncommon clinical entity that manifests as a complication during the acute or convalescent phase of meningococcal meningitis.However,its occurrence within the context of meningococcal septicemia has also been documented.We report a rare case of a previously healthy male patient who developed both acute pericarditis and uveitis as a presentation of meningococcal septicemia,with no characteristic skin rashes or meningeal signs.展开更多
Rationale:Synthetic cannabinoids are increasingly used as recreational drugs and have been associated with adverse cardiovascular effects.However,reports of synthetic cannabinoids accompanied by constrictive pericardi...Rationale:Synthetic cannabinoids are increasingly used as recreational drugs and have been associated with adverse cardiovascular effects.However,reports of synthetic cannabinoids accompanied by constrictive pericarditis are limited.Patient’s concern:A 28-year-old male with a history of synthetic cannabinoid(Bonzai)abuse presented with chest discomfort,dyspnea,and lower extremity edema.Investigations revealed reduced left ventricular ejection fraction,elevated inflammatory markers,low electrocardiogram voltages,and atrial fibrillation.Diagnosis:Chest spiral computerized tomography scan and chest X-ray demonstrated pericardial calcification.Cardiac magnetic resonance imaging and right heart catheterization were done to confirm the possibility of constrictive pericarditis.Based on the patient’s addiction history and exclusion of rheumatologic and infectious causes,it was supposed that constrictive pericarditis and cardiomyopathy may be accompanied by synthetic cannabinoid use.Interventions:The patient received standard medical therapy,including loop diuretics for cardiomyopathy and constrictive pericarditis.Catheter ablation was recommended for his rhythm control,and he was planned for close monitoring of clinical and echocardiographic response and evaluation of the need for surgical pericardiectomy in the future.Outcomes:After 6 months follow-up,echocardiographic exam revealed no significant improvement in ventricular function.However,due to the high surgical risk,the patient’s poor compliance,and the continuation of drug abuse,he was not a good candidate for surgery according to our heart team’s decision.Lessons:Synthetic cannabinoids can trigger constrictive pericarditis,and clinicians should consider them when evaluating patients with compatible symptoms and exposure history.Further research on the cardiovascular effects of synthetic cannabinoids is needed and public education on potential harms is warranted.展开更多
Subdiaphragmatic abscess is the accumulation of pus in the space between the diaphragm and the transverse colon and its mesentery.[1]Subdiaphragmatic abscess is clinically characterized by fever and local pain.Its cli...Subdiaphragmatic abscess is the accumulation of pus in the space between the diaphragm and the transverse colon and its mesentery.[1]Subdiaphragmatic abscess is clinically characterized by fever and local pain.Its clinical manifestations are often vague and diverse,and its symptoms and signs together constitute thoracoabdominal syndrome,leading to delayed diagnosis and a high incidence rate and mortality.[2]Subdiaphragmatic abscess is often secondary to acute peritonitis or remote infection with hematogenous dissemination.The bacteriological characteristics of these abscesses include aerobic and facultative bacteria,such as Escherichia coli,group D Enterococcus and Staphylococcus aureus,as well as less common anaerobic organisms,such as Bacteroides.展开更多
文摘IgG4相关性疾病(IgG4 related disease,IgG4-RD)是一种累及多器官、多系统的自身免疫性疾病。病变累及心包时表现为IgG4相关性心包炎。IgG4-RD临床表现无特异性,尤其对于基础疾病多的老年人,容易漏诊和误诊。本文报道1例老年IgG4相关性心包炎病例,结合文献复习并阐述其诊疗过程,以期提高临床对IgG4相关性心包炎的认识。
文摘Acute pericarditis is usually a self-limiting disorder that commonly occurs due to viral etiology or unexplained causes.Meningococcal pericarditis(MP)is a remarkably uncommon clinical entity that manifests as a complication during the acute or convalescent phase of meningococcal meningitis.However,its occurrence within the context of meningococcal septicemia has also been documented.We report a rare case of a previously healthy male patient who developed both acute pericarditis and uveitis as a presentation of meningococcal septicemia,with no characteristic skin rashes or meningeal signs.
文摘Rationale:Synthetic cannabinoids are increasingly used as recreational drugs and have been associated with adverse cardiovascular effects.However,reports of synthetic cannabinoids accompanied by constrictive pericarditis are limited.Patient’s concern:A 28-year-old male with a history of synthetic cannabinoid(Bonzai)abuse presented with chest discomfort,dyspnea,and lower extremity edema.Investigations revealed reduced left ventricular ejection fraction,elevated inflammatory markers,low electrocardiogram voltages,and atrial fibrillation.Diagnosis:Chest spiral computerized tomography scan and chest X-ray demonstrated pericardial calcification.Cardiac magnetic resonance imaging and right heart catheterization were done to confirm the possibility of constrictive pericarditis.Based on the patient’s addiction history and exclusion of rheumatologic and infectious causes,it was supposed that constrictive pericarditis and cardiomyopathy may be accompanied by synthetic cannabinoid use.Interventions:The patient received standard medical therapy,including loop diuretics for cardiomyopathy and constrictive pericarditis.Catheter ablation was recommended for his rhythm control,and he was planned for close monitoring of clinical and echocardiographic response and evaluation of the need for surgical pericardiectomy in the future.Outcomes:After 6 months follow-up,echocardiographic exam revealed no significant improvement in ventricular function.However,due to the high surgical risk,the patient’s poor compliance,and the continuation of drug abuse,he was not a good candidate for surgery according to our heart team’s decision.Lessons:Synthetic cannabinoids can trigger constrictive pericarditis,and clinicians should consider them when evaluating patients with compatible symptoms and exposure history.Further research on the cardiovascular effects of synthetic cannabinoids is needed and public education on potential harms is warranted.
文摘Subdiaphragmatic abscess is the accumulation of pus in the space between the diaphragm and the transverse colon and its mesentery.[1]Subdiaphragmatic abscess is clinically characterized by fever and local pain.Its clinical manifestations are often vague and diverse,and its symptoms and signs together constitute thoracoabdominal syndrome,leading to delayed diagnosis and a high incidence rate and mortality.[2]Subdiaphragmatic abscess is often secondary to acute peritonitis or remote infection with hematogenous dissemination.The bacteriological characteristics of these abscesses include aerobic and facultative bacteria,such as Escherichia coli,group D Enterococcus and Staphylococcus aureus,as well as less common anaerobic organisms,such as Bacteroides.
