Sheila Kianifar; Abdolreza Malek; Mohammad Ali kiani; Hamid Reza Goldouzi
Abstract
Erythema nodosum (EN) is a condition in which the skin suffers from oval-shaped and tender erythematous patches, mostly on the anterior region of the leg and sometimes other parts of the body, including the arms and affects subcutaneous adipose tissue. These patches are self-limiting and usually heal ...
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Erythema nodosum (EN) is a condition in which the skin suffers from oval-shaped and tender erythematous patches, mostly on the anterior region of the leg and sometimes other parts of the body, including the arms and affects subcutaneous adipose tissue. These patches are self-limiting and usually heal on their own within one to two weeks. This is a case report of a patient who is a 14-year-old boy complained of oval-shaped tender erythematous lesions on the legs of both legs and referred and was hospitalized 5 days ago. The patient continued to complain of pain in both thighs when standing and sitting. The patient developed a high fever upon admission. There was no history of the disease while we were taking his history. All laboratory tests were performed and rheumatic diseases and possible malignancies were evaluated and rejected. The patient was treated with the anti- naproxen, an inflammatory drug, and then the patient’s pain and fever decreased. However, the patient suffered from multiple ulcerative lesions in the mouth on the final day of hospitalization. Infectious counseling was performed and he was discharged with a diagnosis of EN in the context of oral herpes. Two days after discharge, the patient suffered from hematochezia. Consequently, he was hospitalized and underwent colonoscopy, which showed multiple mucosal lesions in the esophagus and duodenum, and a sample was sent for pathology. The test result showed Crohn’s disease, and the patient was treated immediately.
Abdolreza Malek; Forough Rakhshanizadeh; Sheila Kianifar
Abstract
Churg-Strauss syndrome (CSS) is a type of vasculitis of small-to-medium sized vessels. This syndrome is known by a history of bronchial asthma with systemic necrotizing vasculitis and peripheral blood hypereosinophilia. It is currently called eosinophilic granulomatosis with polyangiitis (EGPA). This ...
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Churg-Strauss syndrome (CSS) is a type of vasculitis of small-to-medium sized vessels. This syndrome is known by a history of bronchial asthma with systemic necrotizing vasculitis and peripheral blood hypereosinophilia. It is currently called eosinophilic granulomatosis with polyangiitis (EGPA). This disease affects both genders and all age groups, but it is very rare among children. CSS diagnosis is based on clinical findings such as asthma, eosinophilia, rhinosinusitis, and signs of vasculitis in major organs. In cases where steroids alone or in combination with other immunosuppressive agents are used as treatment, the outcome and long-term survival are usually satisfying. In comparison with other types of systemic vasculitis, the mortality rate of this syndrome is low. In this study, we present the case of a 7-year-old boy with poorly controlled bronchial asthma since three years of age. This case had developed purpuric skin lesions, sinusitis, arthritis, and weakness of the limbs with symptoms of mononeuritis multiplex at the age of seven. After being admitted to our hospital, a series of studies, including complete blood count-diff, chest X-ray, paranasal sinus radiography, brain magnetic resonance imaging, nerve conduction study, spirometry, and serological tests for autoantibodies, were performed and he was diagnosed with CSS. Thereafter, he received regular corticosteroid therapy in combination with methotrexate, and his symptoms were generally well-controlled with the beginning of the treatment. The clinical characteristics, diagnosis, and management of CSS in children are also reviewed in this study.