[Eosinophil granulomatous polyangiitis]
WITTMANN Zsófia, KARDOS Magdolna, FINTHA Attila, KERKOVITS Lóránt, AMBRUS Csaba
JULY 20, 2017
Lege Artis Medicinae - 2017;27(06-07)
WITTMANN Zsófia, KARDOS Magdolna, FINTHA Attila, KERKOVITS Lóránt, AMBRUS Csaba
JULY 20, 2017
Lege Artis Medicinae - 2017;27(06-07)
[Due to the high prevalence of kidney involvement, patients with systemic autoimmune disorders, also including small vessel vasculitides are frequently seen in neph-rology centers. Activated neutrophils attacking the wall of various blood vessel are key features in these diseases, leading to bleeding, occlusion, ischaemia and tissue necrosis. This latter finding is reflected in the term necrotising vasculitis. In this paper, we present a case of eosinophil ganulomatous polyangiitis (EGPA, formerly called Churg-Strauss syndrome), the least common form of ANCA associated small vessel vasculitides. We found it very interesting but not uncommon that our patient was admitted to the nephrology ward with vague symptoms that became more and more suggestive and typical for vasculitis during our observation, guiding us to the right diagnosis. Timely and appropriate immunosuppressive therapy based on immunology lab report and histology findings resulted in good response and remission of the disease in our patient. ]
Lege Artis Medicinae
Lege Artis Medicinae
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Lege Artis Medicinae
Clinical Neuroscience
[The signs and symptoms of acute disseminated encephalomyelitis are heterogeneous and dependent on the location and severity of the inflammatory process. The meningoencephalitic presentation may include meningism, impaired consciousness (occasionally leading to coma), seizures and confusion, or behavioral disturbances. Multifocal neurological features include a combination of optic neuritis, visual field defects, cranial neuropathy, sensorimotor impairment, ataxia, aphasia, and involuntary movements. One definition of acute disseminated encephalomyelitis is “an initial clinical event with a presumed inflammatory and demyelinating cause, with acute or sub-acute onset affecting multifocal areas of the central nervous system”. Patients with acute disseminated encephalomyelitis frequently suffer from seizures, disturbances of consciousness, fever, and headaches, and occasionally there are focal signs and symptoms. Here, we report on two cases who presented with different symptoms, but the clinical findings that the patients showed were benign.]
Clinical Neuroscience
[The aim of our case reports is to demonstrate the therapeutic use and possibilities one has with alemtuzumab, should it be used either as a first or second line therapy. Our first patient's disease in the beginning seemed to be benign. It was not the case however, over several years the diesase showed high activity both radiologically and clinically, she was treated with alemtuzumab as part of an esclationbased therapeutic strategy. The second patient's disease on the other hand showed formidable activity since the very beginning both radiologically and clinically. Therefore we were facing a very disastrous prognosis on the long run, accordingly he received alemtuzumab treatment very early into his illness.]
Lege Artis Medicinae
[Among the main risk factors of cardiovascular disease which is the leading cause of death dyslipidemia has a great importance beyond hypertension, diabetes, smoking and obesity. These conditions rarely occure as isolated ones but very often a clustering of major CV risk factors within individual patients can be observed called metabolic syndrome. It’s a great challenge to convince asymptomatic but high-risk adults that they have to take a lot of medicine for a long time period uninterruptedly to prevent future vascular events (eg. MI or stroke) in the primary care settings. Mainly the low statin-adherence means the greatest problem particularly if a subject should take statin beside two or more drugs despite statins have the most prominent evidences in the field of cardiovascular prevention. The efficacy in improving adherence to therapy of fixed-dose atorvastatin/amlodipin combination was investigated in this paper based on the experiences of case reports derived from our clinical practice.]
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