Relation of severe eosinophilia and microfilariasis to chronic African endomyocardial fibrosis.
Relation of severe eosinophilia and microfilariasis to chronic African endomyocardial fibrosis.
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严重嗜酸性粒细胞增多和微丝蚴病与慢性非洲心内膜心肌纤维化的关系。
DOI：
10.1136/hrt.45.6.672
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发表时间：
1981
影响因子：
--
通讯作者：
O. Soyinka
中科院分区：
文献类型：
--
作者：
J. Andy;F. Bishara;O. Soyinka
在两年的时间里，44名患者的嗜酸性粒细胞计数高于第97百分位数。这44人中有13人在症状发作后6个月内出现心脏病。微丝蚴病是这13例患者中总嗜酸性粒细胞升高的最可能原因。总之，我们使用乙胺嗪（Banocide）后嗜酸性粒细胞计数恢复正常。13例中有11例获得随访，其中8例（73%）出现心脏收缩和三尖瓣返流的临床特征。平均随访时间为2年。在6名患者中进行的有限心脏导管插入术研究显示有缩窄或三尖瓣返流的证据。这8例患者的临床特征与慢性子宫内膜异位症纤维化患者的临床特征无明显区别。1例复发性脑栓塞和1例大量心包积液进一步提示了这种疾病; 1例尸检时也存在这种疾病。因此，微丝蚴诱导的嗜酸性粒细胞增多症，当高时，经常与心脏病有关，心脏病在嗜酸性粒细胞增多症恢复正常后许多月表现为慢性肌内膜纤维化。
Over a two-year period, 44 patients had an eosinophil count above the 97th centile. Thirteen of these 44 had heart disease presenting within six months of the onset of symptoms. Microfilariasis was the most likely cause of the raised total eosinophil in these 13 patients. In all, the raised eosinophil count we returned to normal by the use of diethylcarbamazine (Banocide). Eleven of the 13 were followed up and eight of them (73%) developed clinical features of cardiac constriction and tricuspid regurgitation. The mean duration of follow-up was two years. Limited cardiac catheterisation studies in six of the patients showed evidence of constriction or of tricuspid regurgitation. The clinical features of these eight patients were indistinguishable from those found in chronic endomyocardial fibrosis. This disease was further suggested by recurrent cerebral embolism in one, and a large pericardial effusion in another; and it was also present in the one patient to come to necropsy. Thus, microfilaria-induced eosinophilia, when high, is frequently associated with heart disease which appears to be chronic endomyocardial fibrosis many months after the eosinophilia has returned to normal.