第6巻 2010年2月　第1号

■症例から学ぶ

完全房室ブロックにて発症し，胃生検により確定診断に至った心サルコイドーシスの1例
淀川　顕司¹, 山本　真功¹, 清野　精彦¹, 大秋　美治², 水野　杏一^3
1日本医科大学千葉北総病院循環器センター
²日本医科大学千葉北総病院病理部
³日本医科大学大学院医学研究科器官機能病態内科学

A Case of Cardiac Sarcoidosis with Complete Atrioventricular Block Revealed by Gastric Biopsy
Kenji Yodogawa¹, Masanori Yamamoto¹, Yoshihiko Seino¹, Yoshiharu Ohaki² and Kyoichi Mizuno^3
1)Cardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital
²⁾Division of Surgical Pathology, Nippon Medical School Chiba Hokusoh Hospital
³⁾Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School

A 67-year old woman was emergently admitted because of fainting spells. Electrocardiography showed complete atrioventricular block, and echocardiography demonstrated reduced left ventricular systolic function. Decreased uptake was observed in multiple areas on thallium myocardial scintigraphy; however, coronary angiography showed no significant stenosis. Diffuse left ventricular hypokinesis and complete AV block strongly suggested cardiac sarcoidosis or amyloidosis, but a definitive diagnosis could not be established because histological evidence was lacking. Giant multinucleated cells were incidentally detected on gastric biopsy, and the diagnosis of sarcoidosis was made.

日医大医会誌 2010; 6(1), 30-33

Key words
cardiac sarcoidosis, complete atrioventricular block, gastric biopsy

Correspondence to
Kenji Yodogawa, Cardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inba-mura, Inba-gun, Chiba 270-1694, Japan
E-mail：yodo@nms.ac.jp

受付：2009年8月20日　受理：2009年12月3日