Singh Achintya Dinesh, Suri Tejas Menon, Jagdish Rakesh Kumar, Kumar Uma
Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Pulmonary Medicine Critical Care, All India Institute of Medical Sciences, New Delhi, India.
BMJ Case Rep. 2018 May 12;2018:bcr-2017-223506. doi: 10.1136/bcr-2017-223506.
A 22-year-old man presented with symmetric polyarthritis, pruritus and deviation of angle of mouth to the right side since the last 7 years. His symptoms were persistent despite receiving ayurvedic medications and symptomatic therapy. Examination revealed dry skin, cutaneous nodules, xanthelasma, periarticular non-tender swellings, pitting oedema of hands and feet and lower motor neuron type right facial palsy. Haematological investigations revealed eosinophilia and skin biopsy had cutaneous eosinophilic infiltration. The constellation of above findings comprises the nodules, eosinophilia, rheumatism, dermatitis and swelling syndrome. It a rare syndrome with few reported cases in literature. The patient was started on oral corticosteroids which was subsequently tapered and methotrexate therapy. His polyarthritis and skin rashes resolved with therapy. He has been followed-up for 2 years and is presently asymptomatic for the last 1 year.
一名22岁男性，近7年来出现对称性多关节炎、瘙痒及口角向右侧偏斜。尽管接受了阿育吠陀药物治疗和对症治疗，其症状仍持续存在。检查发现皮肤干燥、皮肤结节、睑黄瘤、关节周围非压痛性肿胀、手足凹陷性水肿以及右下肢运动神经元型面瘫。血液学检查显示嗜酸性粒细胞增多，皮肤活检有皮肤嗜酸性粒细胞浸润。上述表现包括结节、嗜酸性粒细胞增多、风湿、皮炎和肿胀综合征。这是一种罕见综合征，文献报道病例较少。患者开始口服糖皮质激素，随后逐渐减量，并接受甲氨蝶呤治疗。其多关节炎和皮疹经治疗后消退。患者已随访2年，目前最后1年无症状。
