Lege Artis Medicinae

[Eosinophil granulomatous polyangiitis]

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. ]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Interdisciplinary aspects of alcoholism and smoking from the perspective of primary care]

DARVAI László, RIHMER Zoltán, BALCZÁR Lajos, CSERHÁTI Zoltán, TÚRI Gergő, BÉLTECZKI Zsuzsa, KALABAY László, TORZSA Péter

[There is a complex and multi-directional relationship between alcoholism, smoking, depression, anxiety disorders, cardiovascular disorders and type 2 diabetes. They are risk factors not only for each other but - because of their relationship with depression - also for suicide. The effect of successful therapy of depression and anxiety plays a role not only in reducing suicide but also in reduction of alcoholism, cardiovascular morbidity and mortality, and smoking. Therefore, the effect of the appropriate specific treatments appears (even to a lesser extent) also in the field of another medical discipline. On the other hand, the reduction of smoking may be - in addition to decreasing mortality and morbidity of chronic obstructive pulmonary disease, lung cancer, ischemic heart disease, and so on - a causal factor in decreasing suicidal morbidity and mortality, as well as in decreasing morbidity of depression. The purpose of this article is to raise awareness of the relevant professions and healthcare financiers and decision-makers to these hidden benefits (appearing in other fields of expertise). The presented data justify not only the better funding for Mental Health Services but also the extension of the competence of primary care physicians to the mild and moderate (not psychotic and not suicidal) depression and anxiety disorders. ]

Lege Artis Medicinae

[The Hungarian Disease: Fat Deposits on the Upper Back (“csömör”) ]

MAGYAR László András

Lege Artis Medicinae

[Psychart – Art and Psychiatry Exhibition in the Fekete House, Szeged May 5 to 1 September, 2017 ]

FÜRY Anna, GEREVICH József

Lege Artis Medicinae

[Psychiatry and Imaging Historical Overview ]

HÁRDI István

Lege Artis Medicinae

[The Space of the Heart ]

TREMKÓ Mariann

All articles in the issue

Related contents

Clinical Neuroscience

[Change of therapeutic algorithm in sclerosis multiplex based on two case reports]

BIERNACKI Tamás, BENCSIK Krisztina, KINCSES Zsigmond Tamás, SANDI Dániel, FRICSKA-NAGY Zsanett, FARAGÓ Péter, VÉCSEI László

[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.]

Clinical Neuroscience

[Benign-onset acute disseminated encephalomyelitis: A report on two cases]

DEGIRMENCI Eylem, ERDOGAN Cagdas, OGUZHANOGLU Attila, BIR Sinan Levent

[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.]

Lege Artis Medicinae

[How can the fixed-dose atorvastatin/amlodipin combination help better adherence of patients to therapy?]

KIRÁLY Csaba, BENCZÚR Béla

[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.]