Pericardial effusion with tamponade – an uncommon presentation leading to the diagnosis of eosinophilic granulomatosis polyangiitis: A case report  

作　　者：Loba Alam Glenmore Lasam Robert Fishberg 

机构地区：[1]Department of Medicine,Atlantic Health System-Overlook Medical Center,Summit,NJ 07901,United States [2]Department of Cardiology,Icahn School of Medicine,Mount Sinai Heart at Mount Sinai Morningside,New York,NY 10025,United States [3]Department of Cardiology,Atlantic Health System Overlook,Summit,NJ 07901,United States

出　　处：《World Journal of Cardiology》2020年第9期460-467,共8页世界心脏病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Eosinophilic granulomatosis polyangiitis(EGPA)is a small vessel necrotizing vasculitis that commonly presents as peripheral eosinophilia and asthma;however,it can rarely manifest with cardiac involvement such as pericarditis and cardiac tamponade.Isolated pericardial tamponade presenting as the initial symptom of EGPA is exceedingly rare.Early diagnosis and appropriate treatment are crucial to prevent life-threatening outcomes.CASE SUMMARY 52-year-old woman with no past medical history presented with progressive dyspnea and dry cough.On physical exam she had a pericardial friction rub and bilateral rales.Vital signs were notable for tachycardia at 119 beats per minute and hypoxia with 89%oxygen saturation.On laboratory exam,she had 45%peripheral eosinophilia,troponin elevation of 1.1 ng/mL and N-terminal prohormone of brain natriuretic peptide of 2101 pg/mL.TTE confirmed a large pericardial effusion and tamponade physiology.She underwent urgent pericardial window procedure.Pericardial and lung biopsy demonstrated eosinophilic infiltration.Based on the American College of Radiology guidelines,the patient was diagnosed with EGPA which manifested in its rare form of cardiac tamponade.She was treated with steroid taper and mepolizumab.CONCLUSION This case highlights that when isolated pericardial involvement occurs in EGPA,diagnosis is recognized by performing pericardial biopsy demonstrating histopathologic evidence of eosinophilic infiltration.

关 键 词：Eosinophilic granulomatosis polyangiitis Cardiac tamponade Pericardial effusion MEPOLIZUMAB Peripheral eosinophilia Pericardial biopsy Case report 

分 类 号：R543[医药卫生—心血管疾病]