단백 소실성 장병증을 동반한 교착성 심낭염 1례

A case of constrictive pericarditis presenting with protein-losing enteropathy

  • 홍정미 (경희대학교 의과대학 소아과학교실) ;
  • 이재영 (부천세종병원 소아과) ;
  • 김수진 (부천세종병원 소아과) ;
  • 장기영 (부천세종병원 소아과) ;
  • 심우섭 (부천세종병원 소아과)
  • Hong, Jeong Mi (Department of Pediatrics, College of Medicine, Kyunghee University) ;
  • Lee, Jae Young (Department of Pediatric Cardiology, Sejong Heart Institute, Sejong General Hospital) ;
  • Kim, Soo Jin (Department of Pediatric Cardiology, Sejong Heart Institute, Sejong General Hospital) ;
  • Jang, Gi Young (Department of Pediatric Cardiology, Sejong Heart Institute, Sejong General Hospital) ;
  • Shim, Woo Sup (Department of Pediatric Cardiology, Sejong Heart Institute, Sejong General Hospital)
  • 투고 : 2006.02.24
  • 심사 : 2006.05.12
  • 발행 : 2006.08.15

초록

소아에서 교착성 심낭염은 매우 드문 질환으로 이에 의하여 단백 소실성 장병증이 동반되는 경우는 더욱 드물다. 저자들은 교착성 심낭염의 주요 증상의 하나로 단백 소실성 장병증을 보인 여아 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Constrictive pericarditis represents a rare cause of protein-losing enteropathy in children. Reported is an 11-year-old girl with protein-losing enteropathy (PLE) as the principal manifestations of constrictive pericarditis. After total pericardiectomy, symptoms and signs of PLE disappeared. Doppler echocardiography including tissue Doppler imaging is a useful noninvasive initial diagnostic tool for differential diagnosis of diastolic heart failure.

키워드

참고문헌

  1. Davidson JD, Waldmann TA, Goodman DS, Gordon RS. Protein-losing gastroenteropathy in congestive heart failure. Lancet 1961;1:899-902
  2. Jeejeebhoy KN. Cause of hypoalbuminemia in patients with gastrointestinal and cardiac disease. Lancet 1962;1:343-8
  3. Petersen VP, Mastrup J. Protein-losing enteropathy in constrictive pericarditis. Acta Med Scand 1963;173:401-3 https://doi.org/10.1111/j.0954-6820.1963.tb17423.x
  4. Valberg LS, Corbett WEN, McCorriston JR. Excessive loss of plasma protein into the gastrointestinal tract associated with primary myocardial disease. Am J Med 1965;39:668- 73 https://doi.org/10.1016/0002-9343(65)90088-4
  5. Takahashi H, Imai K. What are the objectives of treatment for intestinal lymphangiectasia? J Gastroenterol 2001;36:137- 8 https://doi.org/10.1007/s005350170144
  6. Mertens L, Hagler DJ, Sauer U, Somerville J, Gewillig M. Protein-losing enteropathy after the Fontan operation : an international multicenter study. PLE study group. J Thorac Cardiovasc Surg 1998;115:1063-73 https://doi.org/10.1016/S0022-5223(98)70406-4
  7. Nelson DL, Blaese RM, Strober W, Bruce R, Waldmann TA. Constrictive pericarditis, intestinal lymphangiectasia, and reversible immunologic deficiency. J Pediatr 1975;86: 548-54 https://doi.org/10.1016/S0022-3476(75)80145-4
  8. Koch A, Hofbeck M, Feistel H, Buheitel G, Singer H. Circumscribed intestinal protein loss with deficiency in CD4+ lymphocytes after the Fontan procedure. Eur J Pediatr 1999;158:847-50 https://doi.org/10.1007/s004310051220
  9. Fowler NO. Constrictive pericarditis : its history and current status. Clin Cardiol 1995;18:341-50 https://doi.org/10.1002/clc.4960180610
  10. Talreja DR, Edward WD, Danielson GK, Schaff HV. Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation 2003;108:1852-57 https://doi.org/10.1161/01.CIR.0000087606.18453.FD
  11. Vaitkus PT, Kussmaul WG. Constrictive pericarditis versus restrictive cardiomyopathy : a reappraisal and update of diagnostic criteria. Am Heart J 1991;122:1431-41 https://doi.org/10.1016/0002-8703(91)90587-8
  12. Hatle LK, Appleton CP, Popp RL. Differentiation of constrictive pericarditisve and restrictive cardiomyopathy by Doppler echocardiography. Circulation 1989;79:357-70 https://doi.org/10.1161/01.CIR.79.2.357
  13. Oh JK, Hatle LK, Seward JB, Danielson GK, Schaff HV, Reeder GS, et al. Diagnostic role of Doppler echocardiography in constrictive pericarditis. J Am Coll Cardiol 1994; 23:154-62 https://doi.org/10.1016/0735-1097(94)90514-2
  14. Klein AL, Cohen GI, Pietrolungo JF, White RD, Bailey A, Pearce GL, Stewart WJ, Salcedo EE. Differentiation of constrictive pericarditis from restrictive cardiomyopathy by Doppler transesophageal echocardiographic measurements of respiratory variations in pulmonary venous flow. J Am Coll Cardiol 1993;22:1935-43 https://doi.org/10.1016/0735-1097(93)90782-V
  15. Oh JK, Tajik AJ, Appleton CP, Hatle LK, Nishimura RA, Seward JB. Preload reduction to unmask the characteristic Doppler features of constrictive pericarditis : a new observation. Circulation 1997;95:796-99 https://doi.org/10.1161/01.CIR.95.4.796
  16. Shabetai R. Controversial issues in restrictive cardiomyopathy. Postgrad Med J 1992;68 suppl 1:47-51 https://doi.org/10.1136/pgmj.68.795.47
  17. Garcia MJ, Rodriguez L, Ares M, Griffin BP, Thomas JD, Klein AL. Differentiation of constrictive pericarditis from restrictive cardiomyopathy : assessment of left ventricular diastolic velocities in longitudinal axis by Doppler tissue imaging. J Am Coll Cardiol 1996;27:108-14. https://doi.org/10.1016/0735-1097(95)00434-3
  18. Ha JW, Ommen SR, Tajik AJ, Barnes ME, Ammash NM, Gertz MA, Seward JB, Oh JK. Differentiation of constrictive pericarditis from restrictive cardiomyopathy using mitral annular velocity by tissue Doppler echocardiography. Am J Cardiol 2004;94:316-9 https://doi.org/10.1016/j.amjcard.2004.04.026