[A case of pyoderma gangrenosum after mitral valve replacement].
A 48-year-old male with treated hypothyroidism underwent mechanical valve replacement for mitral valve regurgitation. After the operation, the patient developed progressive median chest wound ulceration. The wound did not heal with conventional therapies for mediastinitis such as administration of antibiotics, debridement of necrotic tissue or continuous irrigation. The entire surgical wound opened spontaneously. Bacterial cultures yielded negative and the wound biopsy specimen revealed non-specific inflammatory change. The anti-TSH receptor antigen level was high. Pyoderma gangrenosum based on auto-immune deficiency was diagnosed and high dose corticosteroid therapy was started. The wound healed completely in 5 months.
Takahashi
R
R
Department of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
Kiso
I
I
Mori
A
A
Inoue
Y
Y
Inoue
Y
Y
D001323:Autoantibodies / Q000032:analysis; D001327:Autoimmune Diseases / Q000150:complications; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007037:Hypothyroidism / Q000150:complications; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D017511:Pyoderma Gangrenosum / Q000188:drug therapy / Q000209:etiology*; D011989:Receptors, Thyrotropin / Q000276:immunology
D001323:Autoantibodies; D011989:Receptors, Thyrotropin; D011239:Prednisolone