埃索诺菲尔粒状瘤与多炎呈现为关动脉血管炎
1Infectious Diseases Unit, 401 General Military Hospital of Athens, Greece.
Mediterranean journal of rheumatology
|November 9, 2023
概括
带有多炎 (EGPA) 的异性粒状炎很少表现为性动脉炎,导致视力丧失. 在这种情况下,迅速诊断和用皮质类固醇治疗导致了完全康复.
科学领域:
- 类风湿病学 类风湿病学
- 神经学 神经学
- 眼科医生 眼科 眼科
背景情况:
- 带有多炎 (EGPA) 的异性粒状炎是一种罕见的全身性血管炎.
- EGPA通常会影响中小型血管,并与喘和eosinophilia有关.
- 时间性动脉炎是大血管血管炎的常见形式,通常影响50岁以上的人.
研究的目的:
- 报告一种罕见的EGPA病例,呈现为关动脉炎.
- 突出考虑EGPA在无法解释的视力丧失和eosinophilia患者中的重要性.
- 为了强调这种罕见的呈现的诊断挑战和治疗结果.
主要方法:
- 一个59岁的男性有视力障碍的病例报告.
- 诊断工作包括完整的血清,成像和动脉活检.
- 进行了针对抗中性粒细胞质抗体 (ANCA) 的血清测试,特别是针对抗髓氧化酶 (anti-MPO/p-ANCA) 的测试.
主要成果:
- 患者呈现出明显的乙氨基和暗示时间性动脉炎的症状.
- 关动脉活检显示血管炎与颗粒状炎症,包括eosinophils.
- 阳性抗MPO/p-ANCA结果支持EGPA的诊断.
结论:
- 不常见地,EGPA可以表现为动脉炎,导致视力丧失.
- 早期诊断和用皮质类固醇 (甲基普雷迪尼索隆脉冲) 治疗导致视力完全恢复.
- 这一案例强调了在动脉炎的差异诊断中需要考虑ANCA相关的血管类.
相关概念视频
01:25Endocarditis II: Clinical Features of Infective Endocarditis
11
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
11
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
10
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
10
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
172
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
172
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
37
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
37
01:23Rheumatic Heart Disease I: Introduction
14
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
14
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
22
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
22