Limits...
CHURG-STRAUSS SYNDROME (1997 Uniformed Services Dermatology Seminar, Case#16) Captain D. Schissel, MC, USA

Cirivello MJC - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: CHURG-STRAUSS SYNDROME (1997 Uniformed Services Dermatology Seminar, Case#16) Captain D. Schissel, MC, USA

History: Patient evaluated for renal insufficiency (bun/creat : 23/1.7), proteinuria (1140mg/24hrs), and microscopic hematuria. He was apparently well until 8 weeks earlier when he developed a papulovesicular facial rash while on active duty in the Persian Gulf. He was treated for "acne" with tetracycline for 10 days with minimal improvement. He then took ibuprofen for several days for muscular back pain. He sought medical attention shortly after he returned to the U.S. due to progressive fatigue, rash, low grade fevers, weight loss, "clumsiness" and inability to concentrate. Other than albuterol and triamcinolone inhalers that he used for chronic well-controlled asthma, he took no other medications, and was previously healthy. There was no prior history or family history of renal disease or urinary abnormalities. There was no gross hematuria, arthritis, oral ulcerations, sinusitis, HA, hemoptysis, cough, chest or abdominal pain or SOB.

Exam: PHYSICAL EXAM: GEN: fatigued appearing thin male with diffuse psychomotor slowing; diffuse petechial rash involving abdomen, chest and back, no organomegaly or masses detected, no bruits; small papular lesions involving dorsum of hands, elbows and feet, splinter hemorrhages, rash per above NEURO: left L5 peroneal nerve cutaneous anesthesia, bilateral S1 clonus R>L LABORATORY: CBC: WBC: 19K, 40% EOS, 94% NEU; HCT:35, PLT:200K, UA: 1013/7.0, 2+ blood, 3+ protein; 24 hr protein 1194 mg CXR: cardiac silhouette mildly enlarged, otherwise normal; ESR: 73, C-reactive protein: 13 (n10-0.6), rheumatoid factor: 115 (nl<10) IgE: 600 Wml (nl 10-150) Streptozyme: positive 1:400 (nl <1:100); ECHO: normal LV function, normal valves, small pericardial effusion; Hepatitis panel: negative; C3: 188 (nl 88-201); C4: 37 (nl 20-59); c-ANCA: negative; p-ANCA: negative, ANA: negative, Cryo: negative; Blood cultures, urine cultures, stool cultures(O+P)- - all negative; SSA/SSB: negative; RPR: NR; HIV: negative; GC cx: negative; Richettsial 96: negative; Brucella Antibody: <1:80 HISTOPATHOLOGY:Two diagnostic procedures were performed. renal bx: cfw Churg Strauss. skin bx: c/w Churg Strauss. Bacterial and fungal cultures - negative

No MeSH data available.


CHURG-STRAUSS SYNDROME
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=MPX1622&req=5

MPX1622_synpic16660: CHURG-STRAUSS SYNDROME


CHURG-STRAUSS SYNDROME (1997 Uniformed Services Dermatology Seminar, Case#16) Captain D. Schissel, MC, USA

Cirivello MJC - MedPix

CHURG-STRAUSS SYNDROME
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1622&req=5

MPX1622_synpic16660: CHURG-STRAUSS SYNDROME

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: CHURG-STRAUSS SYNDROME (1997 Uniformed Services Dermatology Seminar, Case#16) Captain D. Schissel, MC, USA

History: Patient evaluated for renal insufficiency (bun/creat : 23/1.7), proteinuria (1140mg/24hrs), and microscopic hematuria. He was apparently well until 8 weeks earlier when he developed a papulovesicular facial rash while on active duty in the Persian Gulf. He was treated for "acne" with tetracycline for 10 days with minimal improvement. He then took ibuprofen for several days for muscular back pain. He sought medical attention shortly after he returned to the U.S. due to progressive fatigue, rash, low grade fevers, weight loss, "clumsiness" and inability to concentrate. Other than albuterol and triamcinolone inhalers that he used for chronic well-controlled asthma, he took no other medications, and was previously healthy. There was no prior history or family history of renal disease or urinary abnormalities. There was no gross hematuria, arthritis, oral ulcerations, sinusitis, HA, hemoptysis, cough, chest or abdominal pain or SOB.

Exam: PHYSICAL EXAM: GEN: fatigued appearing thin male with diffuse psychomotor slowing; diffuse petechial rash involving abdomen, chest and back, no organomegaly or masses detected, no bruits; small papular lesions involving dorsum of hands, elbows and feet, splinter hemorrhages, rash per above NEURO: left L5 peroneal nerve cutaneous anesthesia, bilateral S1 clonus R>L LABORATORY: CBC: WBC: 19K, 40% EOS, 94% NEU; HCT:35, PLT:200K, UA: 1013/7.0, 2+ blood, 3+ protein; 24 hr protein 1194 mg CXR: cardiac silhouette mildly enlarged, otherwise normal; ESR: 73, C-reactive protein: 13 (n10-0.6), rheumatoid factor: 115 (nl<10) IgE: 600 Wml (nl 10-150) Streptozyme: positive 1:400 (nl <1:100); ECHO: normal LV function, normal valves, small pericardial effusion; Hepatitis panel: negative; C3: 188 (nl 88-201); C4: 37 (nl 20-59); c-ANCA: negative; p-ANCA: negative, ANA: negative, Cryo: negative; Blood cultures, urine cultures, stool cultures(O+P)- - all negative; SSA/SSB: negative; RPR: NR; HIV: negative; GC cx: negative; Richettsial 96: negative; Brucella Antibody: <1:80 HISTOPATHOLOGY:Two diagnostic procedures were performed. renal bx: cfw Churg Strauss. skin bx: c/w Churg Strauss. Bacterial and fungal cultures - negative

No MeSH data available.