颈动脉闭塞与嗜酸性粒细胞增多和蛋白尿有关:潜在的诊断线索还是红鲱鱼?

A. Elavarasi, S. Narayan, S. Parameswaran, D. Gocchait
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引用次数: 0

摘要

肾病综合征和嗜酸性粒细胞增多综合征都是动脉性卒中的罕见病因。我们有一个年轻的患者颈内动脉闭塞,谁有这两种罕见的关联,并被发现有膜性肾病。特发性嗜酸性粒细胞增多症用皮质类固醇和常规的寄生疗法治疗,目的是降低嗜酸性粒细胞计数。肾病综合征也用皮质类固醇和环磷酰胺免疫抑制治疗。血液学异常是动脉血栓形成的重要原因,需要有效的二级预防策略。同样,肾病综合征也不能错过,因为早期治疗可以预防血管并发症。虽然因果关系仍然是假定的,单一的诊断标签难以捉摸,但患者得到早期识别和治疗,预后良好。然而,其他常见的中风原因应该一直被研究,并对复发的预防和治疗进行警惕的随访,这些复发可能会带来毁灭性的后遗症,如完全失明和其他血管疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Carotid Occlusion Associated With Eosinophilia and Proteinuria: Potential Diagnostic Clues or Red Herrings?
Nephrotic syndrome and hypereosinophilic syndrome both are uncommon causes of arterial stroke. We had a young patient with internal carotid artery occlusion, who had both these rare associations and was found to have membranous nephropathy. Idiopathic hypereosinophilia was treated with corticosteroids and conventional parasiticidal therapy with the intention of bringing down the eosinophil count. Nephrotic syndrome was also treated with corticosteroids and immunosuppression with cyclophosphamide. Hematologic abnormalities are an important cause of arterial thrombosis with effective secondary prevention strategies. Similarly, nephrotic syndrome is not to be missed as early treatment may prevent vascular complications. While cause-effect associations remained presumptive and a single diagnostic label elusive, the patient was recognized and treated early and had a good prognosis. However, other common causes of stroke should always be worked up for, and vigilant follow-up mandatory for prevention and treatment of recurrences which can have devastating sequelae such as total blindness and other vascular outcomes.
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