心包填塞是一种心脏被心包液潴留压迫的病况。尽管心包填塞易于诊断，但是鉴别其原因可能较为困难，因为它可由多种病况引起，包括外伤和心包疾病。一名22岁男性因呼吸衰竭被送入重症监护室。他此前接受异基因造血干细胞移植治疗急性髓系白血病，并发生慢性移植物抗宿主病（cGvHD），接受了皮质类固醇治疗。此时，他出现双侧股骨头坏死，并在停用皮质类固醇后接受手术，但术后出现呼吸衰竭。最初的诊断是心力衰竭，通过治疗暂时有所好转；然而，此后出现嗜酸细胞增多症和心包积液。心包积液逐渐加重，导致心包填塞。心包穿刺术得以实施。嗜酸细胞增多症可能是导致心包填塞的原因，因此予以皮质类固醇治疗。皮质类固醇治疗后，心包积液显著改善。皮质类固醇逐渐减量，患者出院。该病例出现了与嗜酸细胞增多症相关的心包填塞，可能与移植物抗宿主病有关。这是一种与血液肿瘤病史有关的不寻常病状，尽管其评估具有挑战性，但适当的评估可能有助于挽救患者的生命。©2023 作者的版权。由Wolters Kluwer Health, Inc.出版。

Cardiac tamponade, a condition in which the heart is compressed by pericardial fluid retention, is easy to diagnose; however, identifying the cause may be challenging since it can be caused by a variety of conditions, including trauma and pericardial disease.A 22-year-old man was admitted to the intensive care unit with respiratory failure. He had previously received allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia and developed chronic graft-versus-host disease (cGvHD) that was treated with a corticosteroid. At this time, he developed bilateral femur head necrosis and underwent surgery after discontinuation of the corticosteroid but developed respiratory failure postoperatively. The initial diagnosis was cardiac failure, which temporarily improved with treatment; however, eosinophilia and pericardial effusions became prominent.Pericardial effusion gradually progressed, resulting in cardiac tamponade.Pericardiocentesis was performed. Eosinophilia could be the cause of cardiac tamponade; thus, corticosteroid was administered.Pericardial effusion improved remarkably after corticosteroid administration. The corticosteroid dose was gradually tapered, and the patient was discharged.This case presented with cardiac tamponade associated with eosinophilia, probably owing to graft-versus-host disease. This is an unusual condition associated with a history of hematologic neoplasms; although evaluation is challenging, appropriate assessment could help save the patient's life.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.