ABSTRACT
La granulomatosis eosinofílica con poliangeítis (GEP), o síndrome de Churg-Strauss, es una rara enfermedad que ocurre en pacientes con asma y eosinofilia y que consiste en una vasculitis necrotizante diseminada con granulomas extravasculares. Clínicamente se manifiesta de manera heterogénea y evoluciona en tres fases: prodrómica (asma y rinosinusitis), eosinofílica (eosinofilia periférica y afectación de los órganos), y vasculítica (manifestaciones clínicas por vasculitis de vasos de pequeño calibre). El diagnóstico diferencial se plantea principalmente con aquellas enfermedades que cursan con hipereosinofilia y con otras vasculitis, siendo necesario un tratamiento temprano para evitar su evolución fatal. Presentamos el caso de un varón de 38 años con antecedentes de asma que -tras un cuadro clínico de mes y medio de evolución de debilidad progresiva, sin fiebre, con diarreas, vómitos y dolor abdominal asociado a pérdida ponderal, que había sido diagnosticado como parasitosis intestinal- falleció por una necrosis miocárdica masiva debida a GEP que afectaba a múltiples órganos
Eosinophilic granulomatosis with polyangiitis (EGPA), or Churg-Strauss syndrome, is a rare disease characterized by disseminated necrotizing vasculitis with extravascular granulomas occurring among patients with asthma and tissue eosinophilia. Clinically, it presents in various ways and progresses in three phases: prodromic (asthma and rhino-sinusitis), eosinophilic (peripheral eosinophilia and organ involvement), and vasculitic (clinical manifestations due to small vessel vasculitis). The differential diagnosis of EGPA principally includes eosinophilic and vasculitic disorders, early treatment is needed to avoid a fatal outcome. We present the case report of a 38-year-old male with a history of asthma. After a month-and-a-half of progressive weakness, no fever, diarrhea, vomiting and abdominal pain associated with weight loss, he was diagnosed of intestinal parasitosis. He later died of a massive myocardial necrosis due to EGPA with multiple organs affected
Subject(s)
Humans , Male , Adult , Granulomatosis with Polyangiitis/diagnosis , Churg-Strauss Syndrome/diagnosis , Hypereosinophilic Syndrome/diagnosis , Diagnosis, Differential , Asthma/complications , Granulomatosis with Polyangiitis/complications , Churg-Strauss Syndrome/complications , Hypereosinophilic Syndrome/complicationsABSTRACT
Eosinophilic granulomatosis with polyangiitis (EGPA), or Churg-Strauss syndrome, is a rare disease characterized by disseminated necrotizing vasculitis with extravascular granulomas occurring among patients with asthma and tissue eosinophilia. Clinically, it presents in various ways and progresses in three phases: prodromic (asthma and rhino-sinusitis), eosinophilic (peripheral eosinophilia and organ involvement), and vasculitic (clinical manifestations due to small vessel vasculitis). The differential diagnosis of EGPA principally includes eosinophilic and vasculitic disorders, early treatment is needed to avoid a fatal outcome. We present the case report of a 38-year-old male with a history of asthma. After a month-and-a-half of progressive weakness, no fever, diarrhea, vomiting and abdominal pain associated with weight loss, he was diagnosed of intestinal parasitosis. He later died of a massive myocardial necrosis due to EGPA with multiple organs affected.
Subject(s)
Abdominal Pain/etiology , Churg-Strauss Syndrome/diagnosis , Intestinal Diseases, Parasitic/diagnosis , Adult , Churg-Strauss Syndrome/physiopathology , Diagnosis, Differential , Fatal Outcome , Humans , Male , Myocardium/pathology , Necrosis/etiology , Weight LossABSTRACT
OBJECTIVE: The present study reviews bladder leiomyoma, an uncommon pathology. The problems of differential diagnosis and the therapeutic options are discussed and the literature reviewed. METHODS/RESULTS: A 33-year-old female with anterolateral intramural leiomyoma of the bladder is described. Patient evaluation included US, cystography, CT, cystoscopy and ultrasound-guided suprapubic puncture. CONCLUSIONS: Leiomyoma is an uncommon benign tumor of the bladder. To our knowledge, only 235 cases have been reported in the literature. We advocate the use of ultrasound-guided suprapubic puncture, a simple procedure that is frequently diagnostic, in the evaluation of this tumor type.
Subject(s)
Leiomyoma , Urinary Bladder Neoplasms , Adult , Female , Humans , Leiomyoma/diagnosis , Urinary Bladder Neoplasms/diagnosisABSTRACT
BACKGROUND: Results of contacts investigation of tuberculous pediatric patients, usually non-infectious, are shown. Their relationship to the clinical situation on index case and the intimacy of exposure is analyzed. METHODS: 714 contacts of 111 pediatric cases (53 category II and 58 category III, according to the American Thoracic Society classification). The tuberculin skin test with 2 units of PPD-RT23 was used to identify the infected persons. Chest radiography, sputum smear and culture examination were used to diagnose current pulmonary disease. According to the intimacy of exposure to index case, contacts were defined as household, close or sporadic contacts. The possible association with clinical situation of index case and intimacy of exposure was analyzed. RESULTS: 41 new cases of tuberculosis were detected, 7 of them were infectious. Prevalence of tuberculous infection among contacts was 44%. Quimioprofilaxis was indicated to 126 contacts. The prevalences of infection and disease according to clinical situation and degree of contact did not differ significantly. CONCLUSIONS: it is advisable to investigate the contacts of tuberculous pediatric patients, even in cases of tuberculous infection without disease; the investigation must include close and sporadic contacts.