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題名 | Pulmonary Alveolar-Septal Amyloidosis Presenting as Heart Failure with Unilateral Pleural Effusion: A Case Report=以心衰竭合併單側肋膜積液為表現的肺泡中膈型類澱粉沉著症:一病例報告 |
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作者 | 劉永揚; 李毓芹; 周德盈; 彭瑞鵬; | 書刊名 | 中華醫學雜誌 |
卷期 | 62:11 1999.11[民88.11] |
頁次 | 頁838-843 |
分類號 | 415.465 |
關鍵詞 | 心衰竭; 肋膜積液; 肺泡中膈型類澱粉沉著症; Congestive heart failure; Pleural effusion; Pulmonary alveolar-septal amyloidosis; |
語文 | 英文(English) |
中文摘要 | 我們報告1 個肺泡中膈型類澱粉沉�摩g合併有乳糜胸和副蛋白質血症的病例。 患者為一位72歲男性,開始以心衰竭合併單側肋膜積液為表現。根據患者的起初臨床表現和胸部X光影像診斷為心衰竭,同時,心臟超音波顯示為同心性左心室肥大和輕微左心室運動功能減退。但經內科治療後,患者右側肋膜積液依然持續,因此安排了肋膜穿刺檢查,發現為乳糜滲出液。為了探查肋膜積液的成因,患者接受了胸廓切開術,病理檢查證實為肺泡中膈型類澱粉沉�摩g,且血清免疫電泳分析亦證實為免疫球蛋白M副蛋白質血症。因此,我們認為對於原因不明的滲出性肋膜積液,應積極探查原因,並將類澱粉沉�摩g列入鑑別診斷中。 |
英文摘要 | We report a case of pulmonary alveolar-septal amyloidosis associated with chylothorax and paraproteinemia initially presenting as congestive heart failure with unilateral pleural effusion. A 72-year-old man was initially diagnosed with congestive heart failure based on the correlation of clinical maifestation and chest radiography. Concentric left ventricular hypertrophy with mild hypokinesis of the left ventricle was found on cardiac echography. Thoracocentesis was performed for right-sided pleural effusion, which persisted despite medical treatment; chylous exudate was aspirated. Becaused the etiology of the exudative pleural effusion was undetermined, the patient underwent a thoracotomy that showed pulmonary alveolar-septal amyloidosis. Immunoglobulin M paraproteinemia was identified by serum immunoelectrophoresis. We conclude that it is imperative to search for the cause of an undetermined exudative pleural effusion, with particular attention to chylothorax and amyloidosis as the differential diagnoses. |
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