Eosinophilic pneumonia and systemic vasculitis

Česká verzia

Authors: K. Letková; A. Uhrinová; M. Čaprnda; Ľ. Gašpar
Authors place of work: Prednosta: doc. MUDr. Ľudovít Gašpar, CSc. ; II. Interná klinika Lekárskej fakulty Univerzity Komenského a Univerzitnej nemocnice, Bratislava
Published in the journal: Prakt. Lék. 2012; 92(5): 290-293
Category: Case Report

Summary

This case report presents a 48 year-old female patient with a 10-year history of bronchial asthma and chronic allergic rhinitis, and with eosinophilia, which was diagnosed 2 years ago. The patient has been repeatedly hospitalized in the pneumology department due to alveolitis and face oedema. In September 2011 the patient was admitted for dyspeptic syndrome, fever and arthralgias. In laboratory values we found marked eosinophilia, chest X-ray showed bilateral infiltrative shadows, which was confirmed by high-resolution computer tomography. Bronchoscopic examination found chronic atrophic tracheobronchitis with acute inflammatory changes and haemorrhagic-purulent secretion. Cytology of bronchoalveolar lavage confirmed significant eosinophilia. Anti-nuclear and anti-neutrophil cytoplasmic antibodies were negative. Patient was treated by pulse therapy with methyl-prednisolone with subsequent subjective relief and objective improvement. The discharge diagnosis was Churg-Strauss syndrome.

Key words:
Churg-Strauss syndrome, eosinophilia, pneumonia, dyspeptic syndrome.

Zdroje

1. Gavorník, P. Končatinovocievne ischemické choroby. In: Gavorník, P., Hrubiško, M., Rozborilová, E. et al. Diferenciálna diagnostika kardio-vaskulárnych, respiračných a hematologických ochorení. I. Bratislava: Dr. Josef Raabe, 2010, s. 1–92.

2. Gavorník P. Všeobecná angiológia. 2. vyd. Bratislava: Vydavateľstvo UK, 2001, 268 s. ISBN 80-223-1608-3.

3. Heczko, M., Gattnarová, Z. Kardiogenní šok jako príčina úmrtí u pacientky se syndromem Churga-Straussové. Cor Vasa, 2011, 53(8-9), s. 493–495.

4. Churg, A. Recent advances in the diagnosis of Churg-Strauss syndrome. Mod. Pathol. 2001, 14(12), p. 1284–1293.

5. Churg, J., Strauss, L. Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am. J. Pathol. 1951, 27(2), p. 277–301.

6. Lukáč, J. Churgov-Straussovej syndróm. In: Lukáč J. Systémové choroby spojivového tkaniva (systémové autoimunitné choroby). Piešťany: Tlačiareň PN print s r.o., 2010, s. 288–291.

7. Masi, A.T., Hunder, G.G., Lie, J.T., et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum. 1990, 33(8), p. 1094–1110.

8. Morgan, J. M., Raposo, L., Gibson, D. G. Cardiac involvement in Churg-Strauss syndrome shown by echocardiography. Br Heart J, 1989, 62(6), p. 462–466.

9. Salanitri, G. C. Endomyocardial fibrosis and intracardiac thrombus occurring in idiopathic hypereosinophilic syndrome. AJR, 2005, 184(5), p. 1432–1433.

10. Solans, R., Bosch, J. A., Pérez-Bocanegra, C., et al. Churg–Strauss syndrome: outcome and long-term follow-up of 32 patients. Rheumatology, 2001, 40(7), p. 763–771.

11. Štvrtinová V., Rovenský, J., Jakubovský J. Churgov-Strausovej syndróm. In: Štvrtinová, V. a kol. Choroby ciev. Bratislava: SAP, 2008, s. 605–607.

12. Tesař V. Vaskulitidy malých tepen. In: Karetová D., Staněk F. a kol. Angiologie pro praxi. Praha: Maxdorf, 2006, s. 171–177.

13. Watts, R. A., Carruthers D. M., Scott, D. G. I. Epidemiology of systemic vasculitis: Changing incidence or definition? Semin Arthritis Rheum, 1995, 25(1), p. 28–34.