Churg-Strauss syndrome physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*Patients with | *Patients with eosinophilic granulomatosis with polyangiitis usually appear ill. | ||
===Vital Signs=== | ===Vital Signs=== | ||
* Fever | |||
* Tachypnea | |||
* Hypertension | |||
* | |||
*Tachypnea | |||
* | |||
===Skin=== | ===Skin=== | ||
*Skin examination of patients with eosinophilic granulomatosis with polyangiitis may show: | *Skin examination of patients with eosinophilic granulomatosis with polyangiitis may show:<ref name="pmid9270504">{{cite journal |vauthors=Davis MD, Daoud MS, McEvoy MT, Su WP |title=Cutaneous manifestations of Churg-Strauss syndrome: a clinicopathologic correlation |journal=J. Am. Acad. Dermatol. |volume=37 |issue=2 Pt 1 |pages=199–203 |date=August 1997 |pmid=9270504 |doi= |url=}}</ref> | ||
**Petechiae | **Petechiae | ||
**Ecchymosis | **Ecchymosis | ||
**Urticarial rash | |||
**Purpura | **Purpura | ||
**Nodules | **Nodules | ||
===HEENT=== | ===HEENT=== | ||
*Sinusitis | *Sinusitis<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> | ||
*Rhinitis | *Rhinitis | ||
*Nasal polyps | *Nasal polyps | ||
| Line 56: | Line 47: | ||
*Inflamed nares / congested nares | *Inflamed nares / congested nares | ||
*Facial tenderness | *Facial tenderness | ||
===Neck=== | ===Neck=== | ||
* Neck examination of patients with [[eosinophilic granulomatosis with polyangiitis]] is usually normal. | * Neck examination of patients with [[eosinophilic granulomatosis with polyangiitis]] is usually normal. | ||
===Lungs=== | ===Lungs=== | ||
The examination may show signs of: | The examination may show signs of:<ref name="pmid21674415">{{cite journal |vauthors=Dunogué B, Pagnoux C, Guillevin L |title=Churg-strauss syndrome: clinical symptoms, complementary investigations, prognosis and outcome, and treatment |journal=Semin Respir Crit Care Med |volume=32 |issue=3 |pages=298–309 |date=June 2011 |pmid=21674415 |doi=10.1055/s-0031-1279826 |url=}}</ref> | ||
*Asthma | *Asthma | ||
**[[Wheeze|Wheezing]] | **[[Wheeze|Wheezing]] | ||
| Line 65: | Line 58: | ||
*Pleural effusion | *Pleural effusion | ||
*Pulmonary hypertension(Basilar crackles) | *Pulmonary hypertension(Basilar crackles) | ||
===Heart=== | ===Heart=== | ||
* | *Examination may show signs of pericarditis, myocarditis and heart failure, myocardial infarction.<ref name="pmid26418389">{{cite journal |vauthors=Brucato A, Maestroni S, Masciocco G, Ammirati E, Bonacina E, Pedrotti P |title=[Cardiac involvement in Churg-Strauss syndrome] |language=Italian |journal=G Ital Cardiol (Rome) |volume=16 |issue=9 |pages=493–500 |date=September 2015 |pmid=26418389 |doi=10.1714/1988.21524 |url=}}</ref> | ||
**Chest pain | |||
**Pericardial friction rub | |||
**Murmurs | |||
* | |||
* | |||
* | |||
* | |||
===Abdomen=== | ===Abdomen=== | ||
Abdominal examination of patients with eosinophilic granulomatosis with polyangiitis may show : | Abdominal examination of patients with eosinophilic granulomatosis with polyangiitis may show : | ||
* [[Tenderness (medicine)|Abdominal tenderness]] | * [[Tenderness (medicine)|Abdominal tenderness]] | ||
* | * Guarding | ||
* Abdominal mass may be found | |||
===Back=== | ===Back=== | ||
* Back examination of patients with [[eosinophilic granulomatosis with polyangiitis]] is usually normal. | * Back examination of patients with [[eosinophilic granulomatosis with polyangiitis]] is usually normal. | ||
===Genitourinary=== | ===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. | * Patient is usually oriented to persons, place, and time. | ||
* [[Peripheral neuropathy]] | * [[Peripheral neuropathy]] | ||
| Line 99: | Line 86: | ||
===Extremities=== | ===Extremities=== | ||
* Extremities examination of patients with [[eosinophilic granulomatosis with polyangiitis]] may show tingling and numbness of extremities. | * Extremities examination of patients with [[eosinophilic granulomatosis with polyangiitis]] may show tingling and numbness of extremities. | ||
* Myalgia | |||
* Arthralgia | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 15:50, 6 April 2018
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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
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Physical Examination
Appearance of the Patient
- Patients with eosinophilic granulomatosis with polyangiitis usually appear ill.
Vital Signs
- Fever
- Tachypnea
- Hypertension
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 and heart failure, myocardial infarction.[4]
- Chest pain
- Pericardial friction rub
- Murmurs
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
- Extremities examination of patients with eosinophilic granulomatosis with polyangiitis may show 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.