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Kokyu to Junkan Volume 43, Issue 1 （January 1995）

呼吸と循環 43巻1号（1995年1月発行）

Japanese English

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症例

心筋萎縮を認めた後天性免疫不全症候群の1剖検例 An Autopsy Case of Acquired Immunodeficiency Syndrome with Cardiac Atrophy 古西満 ¹ , 八木秀男 ¹ , 森啓 ¹ , 濱田薫 ¹ , 前田光一 ¹ , 三笠桂一 ¹ , 澤木政好 ¹ , 成田亘啓 ¹ , 中島充 ² , 吉岡章 ² , 林功 ³ , 坂口泰弘 ³ , 日浅義雄 ³ Mitsuru Konishi ¹ , Hideo Yagi ¹ , Kei Mori ¹ , Kaoru Hamada ¹ , Koichi Maeda ¹ , Keiichi Mikasa ¹ , Masayoshi Sawaki ¹ , Nobuhiro Narita ¹ , Mitsuru Nakashima ² , Akira Yoshioka ² , Isao Hayashi ³ , Yasuhiro Sakaguchi ³ , Yoshio Hiasa ³ ¹奈良県立医科大学第2内科 ²奈良県立医科大学小児科 ³奈良県立医科大学第2病理 ¹2nd Department of Internal Medicine, Nara Medical University ²Department of Pediatrics, Nara Medical University ³2nd Department of Pathology, Nara Medical University キーワード：心筋萎縮 , 後天性免疫不全症候群 , 剖検 , cardiac atrophy , acquired immunodeficiency syndrome , autopsy Keyword: 心筋萎縮 , 後天性免疫不全症候群 , 剖検 , cardiac atrophy , acquired immunodeficiency syndrome , autopsy pp.101-104

発行日 1995年1月15日 Published Date 1995/1/15

DOI https://doi.org/10.11477/mf.1404900997

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Abstract 文献概要
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　欧米では後天性免疫不全症候群（AIDS）の心臓病変が注目されている．今回われわれは心筋萎縮を認めたAIDSの1剖検例を経験したので報告する．症例は28歳，男性．1964年血友病Aと診断，以後血液製剤の投与を受け，HIVに感染，1990年カリニ肺炎・肺非定型抗酸菌症を発症したが，治療で改善，1992年単純ヘルペスのため入院，入院後肺アスペルギルス症による呼吸不全で死亡される．剖検にて心臓重量286g，組織学的に心筋線維束の萎縮がみられ，間隙が目立つが，心筋壊死や炎症細胞浸潤は認めない．AIDS剖検例の心筋萎縮の頻度は0〜9.9％，心筋萎縮症例は悪液質を認めることが多いと報告されている．今後AIDSの症例集積に伴い心臓病変についても詳細な検討が望まれる．

A 28-year-old hemophiliac, who had factor VIII con-centrates since 10 months of age and who was infected with human immunodeficiency virus (HIV), was admit-ted to our hospital because of Pneumocystis carinii pneumonia and atypical mycobacterial disease of the lung in 1990. His symptoms, laboratory data and chest roentgenogram were improved with the administration of ST mixture and antimycobacterial agents, and he was discharged in 1991. He was admitted to our hospi-tal again because of dermatitis due to herpes simplex in March, 1992. He died of respiratory failure due to pulmonary aspergillosis about 3 months later. The autopsy proved that the cardiac weight was 286 g and that, histopathologically, the myocardial fibers were atrophic without necrosis or infiltration of inflam-matory cells.

As cardiac involvement in AIDS is increasingly recognised as an important finding in the United States, the cardiac atrophy found at the autopsy in this case is interesting.