心肌炎是各种原因(病毒感染、免疫系统激活、暴露于毒素或药物等)引起的心肌局限性或弥漫性炎症病变,可导致心脏收缩、舒张功能受损。本文报道1例慢性病程,急性发作,以来势汹汹的呼吸困难、不明原因的心源性休克等为临床表现的慢性活动性心肌炎病例。该病例提示按心脏病常规治疗后临床症状未缓解甚至继续加重时,完善相关检查后排除急性冠脉综合征、缺血性心肌病等,需考虑诊断心肌炎。Myocarditis, characterized by localized or widespread inflammation of the heart muscle, can stem from a variety of triggers such as viral infections, immune system reactions, or exposure to toxins and medications. This condition may result in compromised heart function, affecting both its ability to contract (systolic function) and relax (diastolic function). The case study presented here describes a chronic active myocarditis with a protracted course that manifested acutely, presenting with severe shortness of breath and unexplained cardiogenic shock. It underscores the importance of considering myocarditis as a potential diagnosis when conventional heart disease treatments fail to alleviate symptoms or when they worsen. In such instances, after conducting the necessary diagnostic tests, it is crucial to rule out acute coronary syndrome and ischemic cardiomyopathy before entertaining the possibility of myocarditis.
IgG4相关性疾病(IgG4-related kidney disease, IgG4-RD)是近些年才被认识的一种免疫相关性疾病,发病率较低,发病原因尚不十分明确。现报道一例肾脏受累且肾穿刺活检免疫荧光检查磷脂酶A2受体(PLA2R)阳性的IgG4相关性疾病的诊治过程,以加深临床同道对该病的认识并提高诊疗水平。IgG4-related disease (IgG4-RD) is an immune-related condition that has only been recognized in recent years. It has a relatively low incidence, and its exact cause remains unclear. This article reports the diagnosis and treatment of a case of IgG4-RD with renal involvement and positive phospholipase A2 receptor (PLA2R) by immunofluorescence in renal puncture biopsy, in order to deepen the understanding of the disease and improve the diagnosis and treatment of the clinical colleagues.
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