巨细胞动脉炎患者呼吸困难伴膈膜抬高1例。

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Internal Medicine Pub Date : 2025-07-15 Epub Date: 2025-01-15 DOI:10.2169/internalmedicine.4055-24

Yosuke Asano, Yoshinori Matsumoto, Natsuki Kubota, Yuya Terajima, Kazuya Matsumoto, Kenta Shidahara, Kei Hirose, Takato Nakadoi, Shoichi Nawachi, Yu Katayama, Yoshia Miyawaki, Eri Katsuyama, Takayuki Katsuyama, Mariko Takano-Narazaki, Ken-Ei Sada, Jun Wada

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引用次数: 0

摘要

我们在此报告一例68岁女性活动性巨细胞动脉炎（GCA）伴半膈抬高呼吸困难的病例，并成功治疗。增强ct显示左侧眼动脉和左侧颞浅动脉密度较另一侧降低，软组织增加，提示GCA发作，提示半膈抬高可能是由血管炎相关的右侧膈神经缺血引起的。GCA患者血管炎相关性缺血导致的膈肌麻痹需要与局部感染、肿瘤、肝肿大等膈肌抬高的主要原因区分开来。

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Dyspnea with Hemidiaphragm Elevation in a Patient with Giant Cell Arteritis.

We herein report the first case of dyspnea with hemidiaphragm elevation in a 68-year-old woman with active giant cell arteritis (GCA), including successful treatment. Contrast-enhanced computed tomography showed a reduced density of the left ophthalmic artery and the left superficial temporal artery with increased soft tissue compared to the other side, indicating that the GCA had flared up and suggesting that the hemidiaphragm elevation might be caused by vasculitis-associated ischemia of the right phrenic nerve. Hemidiaphragm paralysis due to vasculitis-associated ischemia in patients with GCA needs to be distinguished from local infection, tumors, and hepatomegaly, which are the major causes of hemidiaphragm elevation.

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来源期刊

Internal Medicine 医学-医学：内科

CiteScore

1.90

自引率

8.30%

发文量

审稿时长

2.2 months

期刊介绍： Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.