Churg-Strauss syndrome physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
A comprehensive physical examination including pulmonary, ENT, neurologic, skin, abdominal and renal systems must be performed to help identify and properly diagnose eosinophilic granulomatosis with polyangiitis form other diseases. On examination, patients may show clinical manifestations of asthma (dyspnea, tachypnea), petechiae, palpable purpura, skin nodules, rhinitis, nasal polyposis, chest pain, abdominal pain, and neurologic manifestations. On auscultation, wheezing, rhonchi, friction rub, abnormal heart sounds may be found.
Physical Examination
Physical examination findings of patients with eosinophilic granulomatosis with polyangiitis depends on organ system involvement. A thorough physical examination can provide insight into possible causes and associated underlying conditions. The following findings may be present during a physical examination of eosinophilic granulomatosis with polyangiitis.
Appearance of the Patient
- Patients with eosinophilic granulomatosis with polyangiitis usually appear ill.
Vital Signs
Skin
- Skin examination of patients with eosinophilic granulomatosis with polyangiitis may show:[1]
- Petechiae
- Ecchymosis
- Urticarial rash
- Purpura
- Nodules
HEENT
- Sinusitis[2]
- Rhinitis
- Nasal polyps
- Otitis media
- Hearing acuity may be reduced
- Weber test may be abnormal
- Rinne test may be abnormal
- Inflamed nares / congested nares
- Facial tenderness
Neck
- Neck examination of patients with eosinophilic granulomatosis with polyangiitis is usually normal.
Lungs
The examination may show signs of:[3]
- Asthma
- Wheezing
- Expiratory ronchi
- Pleural effusion
- Pulmonary hypertension(Basilar crackles)
Heart
- Examination may show signs of pericarditis, myocarditis, heart failure, and myocardial infarction.[4]
Abdomen
Abdominal examination of patients with eosinophilic granulomatosis with polyangiitis may show :
- Abdominal tenderness
- Guarding
- Abdominal mass may be found
Back
- Back examination of patients with eosinophilic granulomatosis with polyangiitis is usually normal.
Genitourinary
- Examination may show signs of glomerulonephritis and renal failure. (eg, anaemia, hypertension, edema, abdominal distension)
Neuromuscular
- Patient is usually oriented to persons, place, and time.
- Peripheral neuropathy
- Mononeuritis multiplex - foot drop, wrist drop[5]
- Cranial nerve palsy
- Stroke
Extremities
- Tingling and numbness of extremities.
- Myalgia
- Arthralgia
References
- ↑ Davis MD, Daoud MS, McEvoy MT, Su WP (August 1997). "Cutaneous manifestations of Churg-Strauss syndrome: a clinicopathologic correlation". J. Am. Acad. Dermatol. 37 (2 Pt 1): 199–203. PMID 9270504.
- ↑ Bacciu A, Bacciu S, Mercante G, Ingegnoli F, Grasselli C, Vaglio A, Pasanisi E, Vincenti V, Garini G, Ronda N, Ferri T, Corradi D, Buzio C (May 2006). "Ear, nose and throat manifestations of Churg-Strauss syndrome". Acta Otolaryngol. 126 (5): 503–9. doi:10.1080/00016480500437435. PMID 16698700.
- ↑ Dunogué B, Pagnoux C, Guillevin L (June 2011). "Churg-strauss syndrome: clinical symptoms, complementary investigations, prognosis and outcome, and treatment". Semin Respir Crit Care Med. 32 (3): 298–309. doi:10.1055/s-0031-1279826. PMID 21674415.
- ↑ Brucato A, Maestroni S, Masciocco G, Ammirati E, Bonacina E, Pedrotti P (September 2015). "[Cardiac involvement in Churg-Strauss syndrome]". G Ital Cardiol (Rome) (in Italian). 16 (9): 493–500. doi:10.1714/1988.21524. PMID 26418389.
- ↑ Wolf J, Bergner R, Mutallib S, Buggle F, Grau AJ (April 2010). "Neurologic complications of Churg-Strauss syndrome--a prospective monocentric study". Eur. J. Neurol. 17 (4): 582–8. doi:10.1111/j.1468-1331.2009.02902.x. PMID 20050889.