Shanker Dinesh Abhijeeth, Kelly Clive, Paul Anupam, Elhardari Sara
Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust.
James Cook University Hospital, Middlesbrough, Cleveland, UK.
Mediterr J Rheumatol. 2022 Mar 31;33(1):88-90. doi: 10.31138/mjr.33.1.88. eCollection 2022 Mar.
We present a 29-year-old gentleman admitted with eight years of recurrent, bilateral, erythematous, macular rash involving the legs, occurring every summer. Other symptoms included intermittent joint aches with dysaesthesia. He was investigated previously with a renal biopsy, a skin biopsy and endoscopy and had been diagnosed as Henoch-Schönlein Purpura (HSP). However, his past medical history included progressive asthma and sinusitis. Investigations revealed peripheral eosinophilia, positive rheumatoid factor and elevated IgE levels with mild renal impairment. During admission, he became hypoxic. A CT pulmonary angiogram (CTPA) showed changes consistent with early pulmonary manifestations of EGPA, which improved on a repeat scan after commencing the patient on high dose prednisolone. Revising the diagnosis, his condition fulfilled criteria for ANCA negative EGPA rather than HSP.
我们报告一位29岁男性，有八年反复出现的双侧腿部红斑性斑疹病史，每年夏天发作。其他症状包括间歇性关节疼痛伴感觉异常。他之前接受过肾活检、皮肤活检和内镜检查，曾被诊断为过敏性紫癜（HSP）。然而，他既往有进行性哮喘和鼻窦炎病史。检查发现外周血嗜酸性粒细胞增多、类风湿因子阳性、IgE水平升高且有轻度肾功能损害。住院期间，他出现了低氧血症。胸部CT血管造影（CTPA）显示的改变符合嗜酸粒细胞性肉芽肿性多血管炎（EGPA）的早期肺部表现，在开始给予患者大剂量泼尼松龙治疗后复查扫描时有所改善。修正诊断后，他的病情符合ANCA阴性EGPA而非HSP的标准。
