Intérêt de l’imagerie par résonance magnétique nucléaire au cours de l’atteinte cardiaque du syndrome de Churg-Strauss. Trois observations et revue de la littérature |
| |
Authors: | G Sauvetre J Fares J Caudron J-N Dacher N Girszyn A Daragon H Levesque I Marie |
| |
Institution: | 1. Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France;2. Service de radiologie, CHU de Rouen, 76031 Rouen cedex, France;3. Service de rhumatologie, CHU de Rouen, 76031 Rouen cedex, France |
| |
Abstract: | PurposeThe reported prevalence of cardiac complications is variable in patients with Churg-Strauss syndrome (15–92%) and depends on diagnostic tools. Diagnosis at early stage of heart involvement is crucial, resulting in appropriate management.MethodsWe report three patients who developed cardiac manifestations, revealing Churg-Strauss syndrome. The diagnosis of cardiac involvement was obtained using cardiac magnetic resonance imaging (MRI).ResultsTwo patients were males and the remaining one was a female. Presenting clinical manifestations were: cardiac failure (n = 1) and retrosternal pain (n = 2). Laboratory findings disclosed: high blood count of eosinophils (range: 6000–11 000/mm3); antineutrophil cytoplasmic antibodies were positive in a single patient. Cardiac MRI demonstrated: (1) late gadolinium enhancement (n = 3), involving mainly the apical and mid-cavity left ventricular segments; (2) impaired left ventricular function (n = 2), mean left ventricular ejection fraction being: 51%; and (3) pericardial effusion (n = 3). Outcome was favourable after institution of combined therapy with prednisone and cyclophosphamide (n = 2); one patient also underwent plasma exchanges.ConclusionOur case series underlines that MRI is a helpful tool in the diagnosis of Churg-Strauss syndrome-related cardiac complications. We further suggest that clinical assessment of patients with Churg-Strauss syndrome should include cardiac MRI, in order to detect cardiac involvement at an early stage; indeed, because cardiac manifestations are predictive factors of poor prognosis, diagnosis at early stages of cardiac involvement may result in improvement of patients management. |
| |
Keywords: | Syndrome de Churg-Strauss Atteinte cardiaque Diagnostic IRM cardiaque Pronostic Traitement |
本文献已被 ScienceDirect 等数据库收录! |
|