Hughes-Stovin syndrome

  • 文章类型: Case Reports
    Behçet综合征(BS)是一种病因不明的罕见慢性多系统炎症性疾病。BS被归类为可变血管大小的血管炎,可以在动脉和静脉血管中表现出来。BS通常表现为粘膜皮肤和眼部表现。50%的患者存在浅静脉和深静脉血栓,非典型静脉血栓形成影响下腔静脉,上腔静脉,肝静脉与Budd-Chiari综合征,门静脉,脑窦,还有右心房和心室.动脉表现包括原位血栓形成,肺动脉动脉瘤,腹主动脉瘤,内脏和外周动脉的动脉瘤。本文报道了一例28岁女性患者出现严重呼吸困难和咯血的新BS病例。超声心动图和心血管磁共振成像可诊断为心内膜心肌纤维化和大的右心室血栓并肺栓塞。计算机断层扫描血管造影显示多发肺动脉瘤和栓塞。注意到罕见的发现,如心内膜心肌纤维化和Budd-Chiari综合征。这个案例强调了医学成像模式在诊断罕见综合征如BS中的作用。正如在目前的情况下所证明的那样。
    Behçet\'s syndrome (BS) is a rare chronic multisystemic inflammatory disorder of unknown etiopathogenesis. BS is classified as a vasculitis of variable vessel size, which can manifest in both arterial and venous blood vessels. BS commonly presents with mucocutaneous and ocular manifestations. Superficial and deep vein thrombosis is present in 50% of patients, with atypical venous thrombosis affecting the inferior vena cava, superior vena cava, hepatic veins with Budd-Chiari syndrome, portal vein, cerebral sinuses, and right atrium and ventricle. Arterial manifestations include in situ thrombosis, pulmonary artery aneurysms, aneurysms of the abdominal aorta, and aneurysms of visceral and peripheral arteries. This article reports a new case of BS in a 28-year-old female patient who presented with severe dyspnea and hemoptysis. Echocardiography and cardiovascular magnetic resonance imaging led to the diagnosis of endomyocardial fibrosis and a large right ventricular thrombus with pulmonary embolism. Computed tomography angiography revealed multiple pulmonary aneurysms and emboli. Rare findings such as endomyocardial fibrosis and Budd-Chiari syndrome were noted. This case highlights the role of medical imaging modalities in diagnosing rare syndromes such as BS, as demonstrated in the current case.
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  • 文章类型: Case Reports
    Hughes-Stovin综合征(HSS)是一种病因不明的罕见血管炎。该疾病的特征是明显的炎症和血管壁的损伤,随后广泛的血管血栓形成和肺动脉动脉瘤的形成,可导致致命的咯血。这种疾病可能会被误认为是其他疾病,如慢性血栓栓塞性肺疾病(CTEPD),无或伴有静息肺动脉高压(CTEPH)。我们报道了一名20岁女性患有HSS的病例,误诊为CTEPH,随后用抗凝血剂治疗,导致严重咯血,最终导致患者死亡。该病例凸显了在疾病早期诊断HSS的挑战。在有大血管血管炎体征的年轻患者中,应考虑HSS,并伴有肺动脉血栓性闭塞,有或没有肺动脉动脉瘤,尤其是,如果没有血栓栓塞性疾病的危险因素。
    Hughes-Stovin syndrome (HSS) is a rare vasculitis of unknown etiology. The disease is characterized by pronounced inflammation and damage to the vessel walls, with subsequent widespread vascular thrombosis and the formation of pulmonary artery aneurysms that can lead to fatal hemoptysis. This disorder can be mistaken for other conditions, such as chronic thromboembolic pulmonary disease (CTEPD) without or with pulmonary hypertension at rest (CTEPH).We report the case of a 20-year-old female with HSS, which was misdiagnosed as CTEPH and subsequently treated with anticoagulants, which led to severe hemoptysis and eventually death of the patient. This case highlights the challenges of diagnosing HSS at early stages of the disease.HSS should be considered in young patients with signs of large vessel vasculitis in combination with thrombotic occlusions of pulmonary arteries, with or without aneurysms of the pulmonary arteries, and particularly, if there are no risk factors for thromboembolic disease.
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  • 文章类型: Journal Article
    三名患有休-斯托温综合征的年轻男性表现为咳嗽,咯血,发烧,炎症标志物升高,和肺动脉瘤.只有一个人复发性口腔溃疡提示Behcet病,HLAB51均无阳性。所有人都对免疫抑制反应良好,但最终需要血管内手术或手术。
    Three young males with Hugh-Stovin\'s syndrome presented with cough, haemoptysis, fever, raised inflammatory markers, and pulmonary artery aneurysm. Only one had recurrent oral ulcers suggestive of Behcet\'s disease, and none were HLA B51 positive. All responded well to immunosuppression but eventually needed either an endovascular procedure or surgery.
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  • 文章类型: Case Reports
    Hughes-Stovin综合征(HSS)是一种罕见的临床疾病,其特征是血栓性静脉炎以及多发性肺和支气管动脉瘤。它通常表现为咳嗽,呼吸困难,发烧,胸痛,咯血,其管理通常包括手术和医疗方法。在这份报告中,我们讨论一例HSS患者。一名30岁的男性患者因咯血入院。胸部CT评估后,观察双侧肺栓塞和肺动脉瘤。由于有口疮性病变的病史,Behçet病(BD)被认为是最初的诊断;然而,患者不符合标准,后来被诊断为HSS.开始静脉注射甲基强的松龙,以及环磷酰胺的维持治疗。在第四个月观察到治疗反应;然而,由于咯血的持续存在,后来需要额外的环磷酰胺循环,患者的病情稳定。HSS目前缺乏明确的诊断标准,需要进一步的研究来调查遗传背景,家族传输,和治疗替代方案。
    Hughes-Stovin Syndrome (HSS) is a rare clinical condition characterized by thrombophlebitis as well as multiple pulmonary and bronchial aneurysms. It commonly presents with coughing, dyspnea, fever, chest pain, and hemoptysis, and its management usually consists of surgical and medical approaches. In this report, we discuss a case of a patient with HSS. A 30-year-old male patient was admitted to the pulmonary medicine ward for hemoptysis. After evaluation with chest CT, bilateral pulmonary embolism and pulmonary aneurysms were observed. Due to a history of aphthous lesions, Behçet\'s disease (BD) was considered the initial diagnosis; however, the patient did not fit the criteria and was later diagnosed with HSS. Intravenous methylprednisolone was initiated, along with a maintenance treatment with cyclophosphamide. Treatment response was observed in the fourth month; however, due to the persistence of hemoptysis, additional cycles of cyclophosphamide were later required, under which the patient\'s condition has been stable. HSS currently lacks clear diagnostic criteria, and further studies are needed to investigate genetic backgrounds, familial transmissions, and treatment alternatives.
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  • 文章类型: Journal Article
    我们介绍了一名青少年男性,有单个心内肿块和肺栓塞,并发外周静脉血栓形成和随后的肺假性动脉瘤的发展,导致Hughes-Stovin综合征的诊断.用环磷酰胺实现缓解,皮质类固醇,和假性动脉瘤切除,并用英夫利昔单抗和甲氨蝶呤维持。
    We present an adolescent male with a single intracardiac mass and pulmonary emboli, complicated by peripheral venous thrombosis and subsequent development of pulmonary pseudoaneurysms, leading to diagnosis of Hughes-Stovin syndrome. Remission was achieved with cyclophosphamide, corticosteroids, and pseudoaneurysm resection and maintained with infliximab and methotrexate.
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  • 文章类型: Journal Article
    Hughes-Stovin综合征是一种罕见的疾病,其特征是血栓性静脉炎和多发性肺和/或支气管动脉瘤。HSS的病因和发病机制尚不完全清楚。目前的共识是血管炎是致病过程的基础,动脉壁炎症后出现肺血栓。因此,Hughes-Stovin综合征可能属于Behçet综合征肺受累的血管簇,虽然口述阿普泰,关节炎,很少发现葡萄膜炎。Behçet综合征是一种多因素多基因疾病,表观遗传,环境,主要是免疫学贡献者。不同的Behçet综合征表型可能是基于涉及一种以上致病途径的不同遗传决定因素。Hughes-Stovin综合征可能与纤维肌肉发育不良和其他随血管动脉瘤发展的疾病有共同的途径。我们描述了符合Behçet综合征标准的Hughes-Stovin综合征病例。检测到未知意义的MYLK变异体,以及其他可能影响血管生成途径的基因杂合突变。我们讨论了这些基因发现的可能参与,以及Behçet/Hughes-Stovin综合征和血管Behçet综合征中动脉瘤的其他潜在共同决定因素。诊断技术的最新进展,包括基因检测,可以帮助诊断特定的Behçet综合征亚型和其他相关疾病,以个性化疾病管理。
    Hughes-Stovin syndrome is a rare disease characterized by thrombophlebitis and multiple pulmonary and/or bronchial aneurysms. The etiology and pathogenesis of HSS are incompletely known. The current consensus is that vasculitis underlies the pathogenic process, and pulmonary thrombosis follows arterial wall inflammation. As such, Hughes-Stovin syndrome may belong to the vascular cluster with lung involvement of Behçet syndrome, although oral aphtae, arthritis, and uveitis are rarely found. Behçet syndrome is a multifactorial polygenic disease with genetic, epigenetic, environmental, and mostly immunological contributors. The different Behçet syndrome phenotypes are presumably based upon different genetic determinants involving more than one pathogenic pathway. Hughes-Stovin syndrome may have common pathways with fibromuscular dysplasias and other diseases evolving with vascular aneurysms. We describe a Hughes-Stovin syndrome case fulfilling the Behçet syndrome criteria. A MYLK variant of unknown significance was detected, along with other heterozygous mutations in genes that may impact angiogenesis pathways. We discuss the possible involvement of these genetic findings, as well as other potential common determinants of Behçet/Hughes-Stovin syndrome and aneurysms in vascular Behçet syndrome. Recent advances in diagnostic techniques, including genetic testing, could help diagnose a specific Behçet syndrome subtype and other associated conditions to personalize the disease management.
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  • 文章类型: Journal Article
    Hughes-Stovin综合征是一种罕见的疾病,其特征是与动脉或支气管动脉瘤相关的血栓性静脉炎。尽管它在1911年首次被描述,但在文献中几乎没有报道。Hughes-Stovin综合征的诊断基于临床表现和放射学发现。没有经过验证的标准或特定的实验室检查结果来确认诊断。计算机断层扫描肺动脉造影仍然是诊断和随访放射学结果的金标准,正如最近在对文献中最大队列的批判性分析中所描述的那样。这篇综述的目的是提请注意这种罕见但可能致命的疾病,并讨论其治疗选择。
    Hughes-Stovin syndrome is a rare disease characterized by thrombophlebitis associated with arterial or bronchial aneurysms. Even though it was described first in 1911, it is scarcely reported in the literature. Hughes-Stovin syndrome diagnosis is based on clinical manifestations as well as radiological findings. There are no validated criteria or specific laboratory findings to confirm the diagnosis. Computed tomography pulmonary angiography remains the gold standard for the diagnosis and follow-up of radiological findings, as they were recently described in a critical analysis of the largest cohort in the literature. The aim of this review is to draw attention to this rare but potentially fatal disease and to discuss its therapeutic options.
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  • 文章类型: Journal Article
    Hughes-Stovin syndrome is a very rare condition with no defined diagnostic criteria. We present the case of a 26-year-old man who had haemoptysis revealing Hughes-Stovin syndrome. We will consider the aetiology, therapeutic and evolutionary aspects of this disease.
    UNASSIGNED: Hughes-Stovin syndrome is a very rare disorder of unknown aetiology which can be fatal.It is considered a variant of Behcet\'s disease.Early diagnosis and treatment improve prognosis.
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  • 文章类型: Case Reports
    Mycobacterium chelonae usually causes localized cutaneous infections and abscesses but has the potential to cause disseminated infections, especially in immunocompromised hosts. We report a 27-year-old man with Hughes-Stovin syndrome and catastrophic antiphospholipid syndrome who was on chronic immunosuppressant therapy and developed disseminated M. chelonae infection. To the best of our knowledge, this is the first case report of M. chelonae infection in a patient with Hughes-Stovin syndrome.
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  • 文章类型: Case Reports
    背景:在1959年首次描述,休斯-斯托温综合征是一种非常罕见的结合血管动脉瘤的疾病,尤其是肺动脉,和血栓形成。该疾病主要影响年轻男性,有时与Behçet病有关。
    方法:这里,我们报道了一例19岁的咯血和呼吸困难患者,尽管进行了有效的抗凝治疗,但仍出现反复的肺栓塞。患者随后出现发热和炎症综合征。体格检查显示舌头溃疡。血管CT显示近期肺栓塞,股静脉血栓形成,和左肺动脉段独特的威胁性动脉瘤。动脉瘤被栓塞,同时插入腔静脉过滤器。
    结论:休斯-斯托温综合征需要立即做出治疗决定,抗凝的重要风险。高剂量类固醇,在大多数情况下,需要强化免疫抑制疗法,如环磷酰胺。
    BACKGROUND: First described in 1959, Hughes-Stovin syndrome is a very rare disorder combining vascular aneurysms, especially from pulmonary arteries, and thrombosis. The disease affects mostly the young male and is sometime associated with Behçet\' disease.
    METHODS: Here, we report the case of a 19-year-old man with hemoptysis and dyspnea revealing recurrent pulmonary embolisms despite efficient anticoagulant therapy. The patient subsequently developed fever and an inflammatory syndrome. Physical examination showed ulcers of the tongue. Angio-CT revealed recent pulmonary embolism, femoral vein thrombosis, and a unique threatening aneurysm of a left pulmonary artery segment. The aneurysm was embolized and simultaneously a vena cava filter was inserted.
    CONCLUSIONS: Hughes-Stovin syndrome requires immediate therapeutic decision, with an important risk of the anticoagulation. High dose steroids and in most cases, intensive immunosuppressive therapies are required such as cyclophosphamide.
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