Churg-Strauss syndrome history and symptoms: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Churg-Strauss syndrome}} | {{Churg-Strauss syndrome}} | ||
{{CMG}}{{APM}}{{AE}} | {{CMG}}{{APM}}{{AE}} {{CK}} | ||
==Overview== | ==Overview== | ||
Obtaining a complete history is an important aspect in making a [[diagnosis]] of [[eosinophilic granulomatosis with polyangiitis]]. As it can help differentiate between the [[Anti-neutrophil cytoplasmic antibody|ANCA]] associated [[vasculitis]] and other possible causes that may mimic the [[disease]]. [[Symptom|Symptoms]] of [[eosinophilic granulomatosis with polyangiitis]] develops through three phases, include prodromal phase, eosinophilic phase, and vasculitis phase. Clinical presentation depends on organ system involvement. Most common symptoms include [[asthma]], [[Rhinosinusitis|sinusitis]], [[myalgia]], [[arthralgia]], [[purpura]], [[Cardiac arrhythmia|arrythmias]], and [[peripheral neuropathy]]. | |||
==History and Symptoms== | ==History and Symptoms== | ||
* | *Obtaining a complete history is an important aspect in making a [[diagnosis]] of [[eosinophilic granulomatosis with polyangiitis]]. | ||
*[[Symptom|Symptoms]] of [[eosinophilic granulomatosis with polyangiitis]] typically develops through three phases, include prodromal phase, eosinophilic phase, and vasculitis phase. Although these phases cannot be clinically distinguishable.<ref name="pmid6366453">{{cite journal |vauthors=Lanham JG, Elkon KB, Pusey CD, Hughes GR |title=Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome |journal=Medicine (Baltimore) |volume=63 |issue=2 |pages=65–81 |date=March 1984 |pmid=6366453 |doi= |url=}}</ref><ref name="pmid9990352">{{cite journal |vauthors=Guillevin L, Cohen P, Gayraud M, Lhote F, Jarrousse B, Casassus P |title=Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients |journal=Medicine (Baltimore) |volume=78 |issue=1 |pages=26–37 |date=January 1999 |pmid=9990352 |doi= |url=}}</ref><ref name="pmid16614512">{{cite journal |vauthors=Oh MJ, Lee JY, Kwon NH, Choi DC |title=Churg-Strauss syndrome: the clinical features and long-term follow-up of 17 patients |journal=J. Korean Med. Sci. |volume=21 |issue=2 |pages=265–71 |date=April 2006 |pmid=16614512 |pmc=2734002 |doi=10.3346/jkms.2006.21.2.265 |url=}}</ref><ref name="pmid25500434">{{cite journal |vauthors=Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Ruoppolo G, Altissimi G, De Vincentiis M |title=Churg-Strauss syndrome |journal=Autoimmun Rev |volume=14 |issue=4 |pages=341–8 |date=April 2015 |pmid=25500434 |doi=10.1016/j.autrev.2014.12.004 |url=}}</ref> | |||
* | **'''Prodromal phase:''' Most common manifestations include [[Rhinitis|allergic rhinitis]] and [[asthma]]. | ||
* | **'''Eosinophilic phase:''' This phase is characterized by [[Eosinophilia|peripheral eosinophilia]] and infiltration of [[Eosinophil granulocyte|eosinophils]] in multiple organs. Most commonly involved organs are [[lung]] and [[Gastrointestinal tract|GI tract]]. | ||
**'''Vasculitic phase:''' This phase is characterized by small and medium-sized [[vasculitis]] and inflammatory granuloma formation. [[Granuloma|Granulomas]] can be either vascular or extravascular. Commonly involved organs include [[Lung|lungs]], [[Kidney|kidneys]], [[skin]], [[heart]], and [[Peripheral nervous system|peripheral nerves]]. | |||
=== | *The following are history and [[Symptom|symptoms]] of [[eosinophilic granulomatosis with polyangiitis]]:<ref name="pmid9990352">{{cite journal |vauthors=Guillevin L, Cohen P, Gayraud M, Lhote F, Jarrousse B, Casassus P |title=Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients |journal=Medicine (Baltimore) |volume=78 |issue=1 |pages=26–37 |date=January 1999 |pmid=9990352 |doi= |url=}}</ref> | ||
**'''Constitutional Symptoms:''' | |||
*[ | ***[[Muscle weakness|Weakness]] | ||
*[ | ***[[Malaise]] | ||
*[ | ***[[Fever]] | ||
***[[Weight loss]] | |||
***[[Arthralgia]] | |||
***[[Fatigue]] | |||
**'''Involvement of [[ear]], [[nose]] and [[throat]]''':<ref name="pmid16698700">{{cite journal |vauthors=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 |title=Ear, nose and throat manifestations of Churg-Strauss syndrome |journal=Acta Otolaryngol. |volume=126 |issue=5 |pages=503–9 |date=May 2006 |pmid=16698700 |doi=10.1080/00016480500437435 |url=}}</ref> | |||
***[[Rhinosinusitis|Sinusitis]] | |||
***[[Rhinitis|Allergic rhinitis]] | |||
***[[Otitis media]] | |||
***[[Nasal polyp|Nasal polyposis]] | |||
***Sensorineural [[Hearing impairment|hearing loss]] | |||
**'''Pulmonary involvement:'''<ref name="pmid29404165">{{cite journal |vauthors=Yılmaz İ, Tutar N, Şimşek ZÖ, Oymak FS, Gülmez İ |title=Clinical and Serological Features of Eosinophilic and Vasculitic Phases of Eosinophilic Granulomatosis with Poliangiitis: a Case Series of 15 Patients |journal=Turk Thorac J |volume=18 |issue=3 |pages=72–77 |date=July 2017 |pmid=29404165 |pmc=5783085 |doi=10.5152/TurkThoracJ.2017.16040 |url=}}</ref> | |||
***[[Dyspnea]] | |||
***[[Chest tightness]] | |||
***[[Cough]] | |||
***[[Hemoptysis]] | |||
***[[Asthma]] | |||
**'''Involvement of [[Gastrointestinal tract|GI tract]]:''' | |||
***[[Acute abdomen]] or [[intestinal angina]] | |||
***[[Bleeding]] | |||
***[[Diarrhea]] | |||
***[[Nausea and vomiting|Vomitings]] | |||
***[[Anorexia]] | |||
**'''Cardiac involvement:'''<ref name="pmid19593229">{{cite journal |vauthors=Neumann T, Manger B, Schmid M, Kroegel C, Hansch A, Kaiser WA, Reinhardt D, Wolf G, Hein G, Mall G, Schett G, Zwerina J |title=Cardiac involvement in Churg-Strauss syndrome: impact of endomyocarditis |journal=Medicine (Baltimore) |volume=88 |issue=4 |pages=236–43 |date=July 2009 |pmid=19593229 |doi=10.1097/MD.0b013e3181af35a5 |url=}}</ref> | |||
***[[Cardiac arrhythmia|Arrythmia]] | |||
***Symptoms related to | |||
****[[Pericarditis]] | |||
****[[Congestive heart failure|Heart failure]] | |||
****[[Myocardial infarction in the elderly|Myocardial infarction]] | |||
****[[Cardiomyopathy]] | |||
**'''Skin involvement''':<ref name="pmid29267447">{{cite journal |vauthors=Marques CC, Fernandes EL, Miquelin GM, Colferai MMT |title=Cutaneous manifestations of Churg-Strauss syndrome: key to diagnosis |journal=An Bras Dermatol |volume=92 |issue=5 Suppl 1 |pages=56–58 |date=2017 |pmid=29267447 |pmc=5726678 |doi=10.1590/abd1806-4841.20175522 |url=}}</ref> | |||
***[[Skin nodules]] on extensor surfaces of arm, legs | |||
***[[Urticaria|Urticarial rash]] | |||
***[[Bruise|Ecchymosis]] | |||
***[[Purpura]] | |||
***[[Petechia|Petechiae]] | |||
**'''Renal involvement''':<ref name="pmid2113641">{{cite journal |vauthors=Clutterbuck EJ, Evans DJ, Pusey CD |title=Renal involvement in Churg-Strauss syndrome |journal=Nephrol. Dial. Transplant. |volume=5 |issue=3 |pages=161–7 |date=1990 |pmid=2113641 |doi= |url=}}</ref> | |||
***[[Glomerulonephritis]] | |||
***[[Hematuria]] | |||
***[[Edema]] | |||
***[[Hypertension]] | |||
**'''Nervous system involvement:'''<ref name="pmid20050889">{{cite journal |vauthors=Wolf J, Bergner R, Mutallib S, Buggle F, Grau AJ |title=Neurologic complications of Churg-Strauss syndrome--a prospective monocentric study |journal=Eur. J. Neurol. |volume=17 |issue=4 |pages=582–8 |date=April 2010 |pmid=20050889 |doi=10.1111/j.1468-1331.2009.02902.x |url=}}</ref> | |||
***[[Mononeuritis multiplex]] | |||
***[[Polyneuropathy]] | |||
***[[Intracranial hemorrhage|Cerebral hemorrhage]] | |||
***[[Infarction|Infarctions]] | |||
***[[Nerve palsy|Cranial nerve palsies]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 17:56, 12 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [3]
Overview
Obtaining a complete history is an important aspect in making a diagnosis of eosinophilic granulomatosis with polyangiitis. As it can help differentiate between the ANCA associated vasculitis and other possible causes that may mimic the disease. Symptoms of eosinophilic granulomatosis with polyangiitis develops through three phases, include prodromal phase, eosinophilic phase, and vasculitis phase. Clinical presentation depends on organ system involvement. Most common symptoms include asthma, sinusitis, myalgia, arthralgia, purpura, arrythmias, and peripheral neuropathy.
History and Symptoms
- Obtaining a complete history is an important aspect in making a diagnosis of eosinophilic granulomatosis with polyangiitis.
- Symptoms of eosinophilic granulomatosis with polyangiitis typically develops through three phases, include prodromal phase, eosinophilic phase, and vasculitis phase. Although these phases cannot be clinically distinguishable.[1][2][3][4]
- Prodromal phase: Most common manifestations include allergic rhinitis and asthma.
- Eosinophilic phase: This phase is characterized by peripheral eosinophilia and infiltration of eosinophils in multiple organs. Most commonly involved organs are lung and GI tract.
- Vasculitic phase: This phase is characterized by small and medium-sized vasculitis and inflammatory granuloma formation. Granulomas can be either vascular or extravascular. Commonly involved organs include lungs, kidneys, skin, heart, and peripheral nerves.
- The following are history and symptoms of eosinophilic granulomatosis with polyangiitis:[2]
- Constitutional Symptoms:
- Involvement of ear, nose and throat:[5]
- Sinusitis
- Allergic rhinitis
- Otitis media
- Nasal polyposis
- Sensorineural hearing loss
- Pulmonary involvement:[6]
- Involvement of GI tract:
- Cardiac involvement:[7]
- Arrythmia
- Symptoms related to
- Skin involvement:[8]
- Skin nodules on extensor surfaces of arm, legs
- Urticarial rash
- Ecchymosis
- Purpura
- Petechiae
- Renal involvement:[9]
- Nervous system involvement:[10]
References
- ↑ Lanham JG, Elkon KB, Pusey CD, Hughes GR (March 1984). "Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome". Medicine (Baltimore). 63 (2): 65–81. PMID 6366453.
- ↑ 2.0 2.1 Guillevin L, Cohen P, Gayraud M, Lhote F, Jarrousse B, Casassus P (January 1999). "Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients". Medicine (Baltimore). 78 (1): 26–37. PMID 9990352.
- ↑ Oh MJ, Lee JY, Kwon NH, Choi DC (April 2006). "Churg-Strauss syndrome: the clinical features and long-term follow-up of 17 patients". J. Korean Med. Sci. 21 (2): 265–71. doi:10.3346/jkms.2006.21.2.265. PMC 2734002. PMID 16614512.
- ↑ Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Ruoppolo G, Altissimi G, De Vincentiis M (April 2015). "Churg-Strauss syndrome". Autoimmun Rev. 14 (4): 341–8. doi:10.1016/j.autrev.2014.12.004. PMID 25500434.
- ↑ 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.
- ↑ Yılmaz İ, Tutar N, Şimşek ZÖ, Oymak FS, Gülmez İ (July 2017). "Clinical and Serological Features of Eosinophilic and Vasculitic Phases of Eosinophilic Granulomatosis with Poliangiitis: a Case Series of 15 Patients". Turk Thorac J. 18 (3): 72–77. doi:10.5152/TurkThoracJ.2017.16040. PMC 5783085. PMID 29404165.
- ↑ Neumann T, Manger B, Schmid M, Kroegel C, Hansch A, Kaiser WA, Reinhardt D, Wolf G, Hein G, Mall G, Schett G, Zwerina J (July 2009). "Cardiac involvement in Churg-Strauss syndrome: impact of endomyocarditis". Medicine (Baltimore). 88 (4): 236–43. doi:10.1097/MD.0b013e3181af35a5. PMID 19593229.
- ↑ Marques CC, Fernandes EL, Miquelin GM, Colferai M (2017). "Cutaneous manifestations of Churg-Strauss syndrome: key to diagnosis". An Bras Dermatol. 92 (5 Suppl 1): 56–58. doi:10.1590/abd1806-4841.20175522. PMC 5726678. PMID 29267447. Vancouver style error: initials (help)
- ↑ Clutterbuck EJ, Evans DJ, Pusey CD (1990). "Renal involvement in Churg-Strauss syndrome". Nephrol. Dial. Transplant. 5 (3): 161–7. PMID 2113641.
- ↑ 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.