WordNet

a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"

PrepTutorEJDIC

(疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/01/25 12:39:50」(JST)

wiki en

Dressler's syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever, pleuritic pain, pericarditis and/or a pericardial effusion.

Dressler's syndrome is also known as postmyocardial infarction syndrome^[1] and the term is sometimes used to refer to post-pericardiotomy pericarditis.

It was first characterized by William Dressler at Maimonides Medical Center in 1956.^[2]^[3]^[4]

It should not be confused with the Dressler's syndrome of haemoglobinuria named for Lucas Dressler, who characterized it in 1854.^[5]^[6]

Presentation

Dressler's syndrome occurs in about 7% of myocardial infarctions,^[7] and consists of a persistent low-grade fever, chest pain (usually pleuritic in nature), pericarditis (usually evidenced by a pericardial friction rub), and/or a pericardial effusion. The symptoms tend to occur 2–3 weeks after myocardial infarction, but can also be delayed for a few months. It tends to subside in a few days, and very rarely leads to pericardial tamponade.^[8] An elevated ESR is an objective laboratory finding.

Causes

It is believed to result from an autoimmune inflammatory reaction to myocardial neo-antigens formed as a result of the MI. A similar pericarditis can be associated with any pericardiotomy or trauma to the pericardium or heart surgery.

Differential diagnosis

Dressler's syndrome needs to be differentiated from pulmonary embolism, another identifiable cause of pleuritic (and non-pleuritic) chest pain in people who have been hospitalized and/or undergone surgical procedures within the preceding weeks.

Treatment

Dressler's syndrome is typically treated with colchicine. In some resistant cases, corticosteroids can be used but are not preferred due to the high frequency of relapse when corticosteroid therapy is discontinued. NSAIDs though once used to treat Dressler syndrome, are less advocated and should be avoided in patients with ischemic heart disease. One NSAID in particular, indomethacin can inhibit new collagen deposition thus impairing the healing process for the infarcted region. NSAIDS should only be used in cases refractory to aspirin. Heparin in Dressler syndrome should be avoided because it can lead to hemorrhage into the pericardial sac leading to tamponade. The only time heparin could be used with pericarditis is with coexisting acute MI in order to prevent further thrombus formation.^[9]

References

^ Hutchcroft BJ (July 1972). "Dressler's syndrome". Br Med J 3 (5817): 49. doi:10.1136/bmj.3.5817.49-a. PMC 1788531. PMID 5039567.
^ Bendjelid K, Pugin J (November 2004). "Is Dressler syndrome dead?". Chest 126 (5): 1680–2. doi:10.1378/chest.126.5.1680. PMID 15539743.
^ Streifler J, Pitlik S, Dux S, et al. (April 1984). "Dressler's syndrome after right ventricular infarction". Postgrad Med J 60 (702): 298–300. doi:10.1136/pgmj.60.702.298. PMC 2417818. PMID 6728756.
^ Dressler W (January 1959). "The post-myocardial-infarction syndrome: a report on forty-four cases". AMA Arch Intern Med 103 (1): 28–42. doi:10.1001/archinte.1959.00270010034006. PMID 13605300.
^ synd/3982 at Who Named It?
^ L. A. Dressler. Ein Fall von intermittirender Albuminurie und Chromaturie. Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, 1854, 6: 264-266.
^ Krainin F, Flessas A, Spodick D (1984). "Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram". N Engl J Med 311 (19): 1211–4. doi:10.1056/NEJM198411083111903. PMID 6493274.
^ Hertzeanu, H; Almog, C; Algom, M (1983). "Cardiac tamponade in Dressler's syndrome. Case report.". Cardiology 70 (1): 31–6. doi:10.1159/000173566. PMID 6850684. |accessdate= requires |url= (help)
^ Jaffe AS, Boyle AJ. Chapter 5. Acute Myocardial Infarction. In: Crawford MH, ed. CURRENT Diagnosis & Treatment: Cardiology. 3rd ed. New York: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=3646487. Accessed June 16, 2012

External links

-1140457467 at GPnotebook
For antibody to cardiac muscle
Dressler's syndrome on CNN

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 心臓傷害後症候群 post cardiac injury syndromes
2. 心臓手術後の胸水 pleural effusions following cardiac surgery
3. 心筋梗塞の心膜合併症 pericardial complications of myocardial infarction
4. 心膜疾患の病因 etiology of pericardial disease
5. 冠動脈バイパス術の早期心合併症 early cardiac complications of coronary artery bypass graft surgery

English Journal

Extremely high ferritin level after an acute myocardial infarction in an end stage renal disease patient.

Sandhu G, Mankal P, Gupta I, Tagani A, Ranade A, Jones J, Bansal A.
Clinical nephrology.Clin Nephrol.2014 Jul;82(1):68-72. doi: 10.5414/CN107696.
We present here a case of an asymptomatic end-stage renal disease (ESRD) patient, who had an unexplained persistent mild leukocytosis in the setting of an extremely high ferritin level (8,997 ng/ml; reference range: 12 - 300 ng/ml) 3 weeks after she suffered from a myocardial infarction (MI). Infect
PMID 23211338

Visualizing pericardial inflammation in Dressler's syndrome with cardiac magnetic resonance imaging.

Lawley C, Mazhar J, Grieve SM, Figtree GA.
International journal of cardiology.Int J Cardiol.2013 Sep 20;168(1):e32-3. doi: 10.1016/j.ijcard.2013.05.082. Epub 2013 Jun 14.
PMID 23769683

Causes and management of common benign pleural effusions.

Thomas R1, Lee YC.
Thoracic surgery clinics.Thorac Surg Clin.2013 Feb;23(1):25-42, v-vi. doi: 10.1016/j.thorsurg.2012.10.004.
Benign pleural effusions are twice as common as malignant effusions and have diverse causes and manifestations, which often makes them a diagnostic challenge. Differentiating effusions as a transudate or exudate is the first, and often helpful, step in directing investigations for diagnosis and mana
PMID 23206715

Japanese Journal

心筋梗塞後症候群 (冠動脈疾患(下)診断と治療の進歩) -- (心筋梗塞(ST上昇型)の臨床)

高橋宏,長尾健
日本臨床 69 (1010増刊9), 226-229, 2011-11
NAID 40019061797

Steroid が著効した Dressler's syndrome の1例(日本循環器学会第69回九州地方会)

中村夏樹,菊田浩一,増田武信,中尾宏,黒岩英
Japanese circulation journal 56(Supplement_III), 978, 1992-07-20
NAID 110004570588

「心筋梗塞後症候群」

Dressler's syndrome
Classification and external resources
ICD-10	I24.1
ICD-9	411.0
DiseasesDB	3947

　　[★]

英: post-myocardial infarction syndrome, postmyocardial infarction syndrome
同: ドレスラー症候群, Dressler症候群, Dressler's syndrome, Dressler syndrome
関: 心筋梗塞

概念

様々な呼び方がある。(参考1)

post cardiac injury syndrome PCIS
Dressler's syndrome
postpericardiotomy syndrome
[心筋梗塞後に起こった物について特に]postmyocardial infarction syndrome (Post-MI fibrinous pericarditis)

疫学・病因：心臓手術後だけでなく心筋梗塞後や肺塞栓後でも起こり、これらの患者のうちPCISを起こす患者は3.5%であったという報告がある。PCISは歴史的には1956年にDresslerによって急性心筋後、数週間から数ヶ月後に起こると報告されいるが、まれに心筋梗塞後1週間以内に症状が出現することがある。(参考1)　　
病態・症状：胸膜痛(pleuritic chest pain)、胸膜摩擦音、発熱、白血球増多、時に胸水・肺浸浸潤影(pulmonary infiltrate)。(参考1)　　←　　心筋梗塞後1週間以内に見られる急性心膜炎とは症状や経過が違うらしい。
病態生理：免疫性因子の関与が想定されている。心筋障害により心臓由来の抗原が放出され抗体形成を刺激、免疫複合体を形成後に心膜、胸膜、肺に沈着する。免疫複合体に対して炎症反応が惹起されるのが本態とされる。(参考1)

参考

1. [charged] Pericardial complications of myocardial infarction - uptodate [1]

「線維素性心膜炎」

　　[★]

英: fibrinous pericarditis
同: 乾性心膜炎 dry pericarditis、serofibrinous pericarditis
関: [[]]

friction rub

尿毒症、全身性エリテマトーデスでfibrinous pericarditisを伴う

diffuse fibrinous pericarditis is more typical of systemic conditions such as uremia or SLE, whereas focal pericarditis may overlie a transmural MI(Dressler syndrome)

「syndrome」

　　[★]

n.

症候群

[pmid5039567-1] Hutchcroft BJ (July 1972). "Dressler's syndrome". Br Med J 3 (5817): 49. doi:10.1136/bmj.3.5817.49-a. PMC 1788531. PMID 5039567.

[pmid15539743-2] Bendjelid K, Pugin J (November 2004). "Is Dressler syndrome dead?". Chest 126 (5): 1680–2. doi:10.1378/chest.126.5.1680. PMID 15539743.

[pmid6728756-3] Streifler J, Pitlik S, Dux S, et al. (April 1984). "Dressler's syndrome after right ventricular infarction". Postgrad Med J 60 (702): 298–300. doi:10.1136/pgmj.60.702.298. PMC 2417818. PMID 6728756.

[pmid13605300-4] Dressler W (January 1959). "The post-myocardial-infarction syndrome: a report on forty-four cases". AMA Arch Intern Med 103 (1): 28–42. doi:10.1001/archinte.1959.00270010034006. PMID 13605300.

[5] synd/3982 at Who Named It?

[6] L. A. Dressler. Ein Fall von intermittirender Albuminurie und Chromaturie. Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, 1854, 6: 264-266.

[7] Krainin F, Flessas A, Spodick D (1984). "Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram". N Engl J Med 311 (19): 1211–4. doi:10.1056/NEJM198411083111903. PMID 6493274.

[8] Hertzeanu, H; Almog, C; Algom, M (1983). "Cardiac tamponade in Dressler's syndrome. Case report.". Cardiology 70 (1): 31–6. doi:10.1159/000173566. PMID 6850684. |accessdate= requires |url= (help)

[9] Jaffe AS, Boyle AJ. Chapter 5. Acute Myocardial Infarction. In: Crawford MH, ed. CURRENT Diagnosis & Treatment: Cardiology. 3rd ed. New York: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=3646487. Accessed June 16, 2012

リンク元	「心筋梗塞後症候群」「線維素性心膜炎」
関連記事	「syndrome」

匿名

検索

案内

案内

Dressler syndrome