PDF(Pubmed)
Abstract：
Cardiac extraintestinal manifestations (EIMs) of Crohn\'s disease (CD) are uncommon. They include pericarditis, myocarditis, and arrhythmias; however, distinguishing these from alternative causes including medication-related adverse effects is often challenging. Leukocytoclastic vasculitis is another uncommon EIM of CD that may present with systemic involvement. We present a rare case of myocarditis associated with leukocytoclastic vasculitis occurring as EIMs of CD. The myocarditis proved refractory to standard therapy and biologics targeting underlying gut inflammation. She developed an inflammatory cardiomyopathy and symptoms consistent with heart failure with preserved ejection fraction. Anakinra was tried, but despite the initial response, it should be used cautiously in patients with CD.
摘要：
克罗恩病（CD）的心脏肠外表现（EIMs）并不常见。包括心包炎,心肌炎,和心律失常；然而，将这些因素与包括药物相关不良反应在内的其他原因区分开来通常具有挑战性.白细胞碎裂性血管炎是CD的另一种罕见的EIM，可能伴有全身受累。我们介绍了一例罕见的与白细胞碎裂性血管炎相关的心肌炎病例，其发生为CD的EIM。心肌炎被证明是标准疗法和针对潜在肠道炎症的生物制剂难以治疗的。她出现了炎症性心肌病，症状与心力衰竭一致，射血分数保留。Anakinra被审判了,但是尽管有最初的反应，CD患者应谨慎使用。
