scholarly journals GRANULOMATOSIS WITH POLYANGIITIS (WEGENER): FEATURES OF DIAGNOSIS IN CONDITIONS OF COVID-19 INFECTION (CLINICAL CASE)

2021 ◽  
Vol 19 (3) ◽  
pp. 331-334
Author(s):  
N. V. Hlutkina ◽  
Keyword(s):  
Respiratory Failure ◽  
Otitis Media ◽  
Clinical Case ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Organ Damage ◽  
Multiple Organ ◽  
State Of Health ◽  
Moderate Severity ◽  
The Given

Background. Multivascular and multiple organ damage in COVID-19 infection poses difficulties in the diagnosis of comorbidities, especially vasculitis. Aim. The goal is to analyze a clinical case of diagnosing granulomatosis with polyangiitis (Wegener) in conditions of COVID-19 infection. Material and methods. An example of the difficulty of diagnosing granulomatosis with polyangiitis (Wegener) in conditions of COVID-19 infection is given. Results. Within three months, the patient received treatment for sinusitis, otitis media. However, against the background of the antibacterial therapy, the state of health did not improve. On the fourth month from the onset of the disease, the patient was admitted to the pulmonology department with a diagnosis of a viral infection caused by SARS Cov-2 (IgM +, IgG-), moderate severity, respiratory failure 0 ?, after the examination, the diagnosis was made: granulomatosis with polyangiitis (Wegener's), acute course, high activity associated with antibodies to Pr-3 (79 n/ml), advanced stage with lesions of ENT organs in the form of exudative otitis media, bilateral mastoiditis. The damage to the lungs in the form of endobronchitis, pulmonary disseminated form (partly with disintegration). respiratory failure 1. Reconvalescent of SARS Cov-2 infection. Conclusions. Based on the given example of this clinical case, the difficulty of diagnosing systemic vasculitis, namely granulomatosis with polyangitis (Wegener's), in conditions of COVID-19 infection is demonstrated.

scholarly journals Difficulties in the differential diagnosis of granulomatosis with polyangiitis and scarring pemphigoid

2020 ◽  
Vol 10 (5) ◽  
pp. 398-402
Author(s):  
N. A. Magdeeva ◽  
A. A. Kobriseva ◽  
M. A. Reznikova ◽  
I. F. Melehina
Keyword(s):  
Differential Diagnosis ◽  
Renal Damage ◽  
Clinical Case ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Organ Damage ◽  
Pathological Process ◽  
Poor Knowledge ◽  
Eye Damage ◽  
Positive Results

The article presents a clinical case of a rare pathology. The patient for several years visited various specialists. In connection with a similar clinical picture, multi-organ damage, differential diagnosis was performed between systemic vasculitis (granulomatosis with polyangiitis) and scarring pemphigoid.The mucous membrane of the mouth and nose is involved in the pathological process with granulomatosis with polyangiitis in the form of ulcerative defects, which subsequently lead to deformation of the nose. The danger with this systemic vasculitis is renal damage with the development of nephritis, renal failure. With scarring pemphigoid, eye damage is typical. In granulomatosis with polyangiitis, damage to the organ of vision is also sometimes possible, but mainly in the form of an orbit pseudotumor. Despite the fact that treatment for both forms of pathology involves the use of glucocorticoids and cytostatics, with a scarring pemphigoid, the main care is provided by dermatologists and ophthalmologists, while the diagnosis and treatment of systemic vasculitis is the task of rheumatologists. One of the criteria for a scarring pemphigoid is loss of vision. However, in this case, it was possible to establish a diagnosis, obtain the first positive results of therapy before the patient shows signs of disability. So, there is a hope for the possibility of preserving vision and a favorable outcome. The rarity of the disease and its poor knowledge, difficulties in diagnosis and the absence of certain standards of therapy, this diagnosis requires more attention from the specialists.

scholarly journals ANCA-associated vasculitis in a 14 years-old patient: a clinical case

2020 ◽  
Vol 27 (5) ◽  
pp. 184-194
Author(s):  
A. V. Burlutskaya ◽  
N. V. Savelyeva ◽  
N. S. Тaran
Keyword(s):  
Respiratory Failure ◽  
Immunosuppressive Therapy ◽  
Clinical Case ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Pulse Therapy ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Anca Associated Vasculitis ◽  
Nasal Bleeding ◽  
Diagnostic Research

Background. ANCA-associated systemic vasculitis is a rare childhood disease. Antineutrophil cytoplasmic autoantibodies (ANCA)-related vasculitises include microscopic polyangiitis, granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis. Their rarity often leads to a late diagnosis, rapid disability and high mortality in patients due to aggressive respiratory, pulmonary lesion and renal failure.Clinical Case Description. The patient suffered from a recurrent bronchoobstructive syndrome with signs of respiratory failure, obscure origin fever and chronic rhinitis with nasal bleeding for 6 months. The patient was diagnosed with obstructive bronchitis (putative bronchial asthma debut), received antibacterial therapy and inhalation bronchodilators without stable improvement during the entire period. Skin haemorrhages and arthralgia stimulated diagnostic research to establish ANCA-associated systemic vasculitis (presence of proteinase 3-specifi c ANCAs in titre 1/80). CT lung scanning revealed frosted glass foci of reduced pulmonary pneumatisation and signs of bilateral bronchoobstruction. Immunosuppressive therapy with glucocorticosteroids (methylprednisolone pulse therapy No. 3, 1000 mg intravenously on alternate days, subsequent per os administration of 1 mg/kg/day) and cyclophosphamide (500 mg intravenously once per 28 days) was prescribed. This led to the positive dynamics with eliminated fever and skin haemorrhages, as well as essentially reduced signs of respiratory failure.Conclusion. Diagnosis of systemic vasculitis is often complicated and long-term due to commonly non-specifi c debut symptoms of autoimmune disorders. In the described case, the fi rst 6 months of illness displayed intoxication and bronchoobstruction with signs of respiratory failure. Haemorrhagic rashes, arthralgias and the presence of ANCAs are proxy to vasculitis. Standard immunosuppressive therapy for ANCA-associated vasculitis improved the patient’s condition.

Granulomatosis with polyangiitis: a clinical case

2021 ◽  
Vol 7 (1) ◽  
pp. 14-17
Author(s):  
A. Fleyshman
Keyword(s):  
Clinical Manifestation ◽  
Clinical Case ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Multiple Organ ◽  
Over Time

: Diagnosis of systemic vasculitis is difficult due to a low-symptomatic or atypical debut, as well as an insufficiently bright clinical manifestation. The article presents a clinical case of granulomatosis with polyangiitis in a young man with multiple organ symptoms, stretched over time.

scholarly journals Bronchial asthma «masks» are not always easy to recognize.Case report

2011 ◽  
Vol 8 (6) ◽  
pp. 17-20
Author(s):  
I I Isakova ◽  
S A Pol'ner ◽  
I S Gushchin ◽  
I I Isakova ◽  
S A Polner ◽  
...  
Keyword(s):  
Clinical Case ◽  
Pulse Therapy ◽  
Multiple Organ ◽  
Cytostatic Agents ◽  
Autoimmune Process ◽  
Disease Remission ◽  
Strauss Syndrome ◽  
The Given ◽  
Churg Strauss ◽  
Peripheral Blood Eosinophilia

Clinical case of Churg-Strauss syndrome was described in 36-year old female patient in the course of its development since the disease suggested start. Churg-Strauss syndromes manifestations were characterized by high peripheral blood eosinophilia and multiple organ lesions, here include airways, heart (exudative pericarditis), and skin (urticaria). The prescribed therapy involved cytostatic agents and pulse therapy with glucocorticoids slowly reducing up to maintaining dose. In the course of the therapy a stable clinical disease remission was registered. Maximally fast diagnostics of the given syndrome provides immediate start of therapy and holds up autoimmune process. Both contribute to significant decrease of cases with severe forms and possible complications.

scholarly journals Otitis media with effusion as an initial manifestation of granulomatosis with polyangiitis

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110360
Author(s):  
Dragoslava Djerić ◽  
Aleksandar Perić ◽  
Bojan Pavlović ◽  
Miljan Folić ◽  
Ana Bontić ◽  
...  
Keyword(s):  
Otitis Media ◽  
Granulomatosis With Polyangiitis ◽  
Otitis Media With Effusion ◽  
Systemic Vasculitis ◽  
Kidney Tissue ◽  
Complete Recovery ◽  
Unknown Etiology ◽  
Histopathological Analysis ◽  
Initial Manifestation ◽  
Rapidly Progressive Renal Failure

Granulomatosis with polyangiitis is a systemic vasculitis of unknown etiology, characterized by necrotizing granulomas. It is an autoimmune disease affecting small- and medium-sized vessels of upper and lower respiratory tract, kidneys, and other organs. We described a case of a patient with otitis media with effusion as the first manifestations of granulomatosis with polyangiitis. A 54-year-old female presented as an urgent case with history of a severe otalgia, hearing loss, vertigo, and fever. The patient was treated with diagnosis of otitis media with effusion and acute rhinosinusitis, but without significant success. She developed an acute kidney dysfunction as a sign of glomerulonephritis with rapidly progressive renal failure. Diagnosis of granulomatosis with polyangiitis was confirmed after the histopathological analysis of kidney tissue, not by analysis of middle ear and paranasal sinus mucosa specimens. The patient was treated according to generally accepted protocol, and over time, there was an almost complete recovery.

scholarly journals Listeriosis: the review of a problem, presentation of a clinical case of listeria sepsis in a 4-month child

2021 ◽  
Vol 9 (4) ◽  
pp. 39-42
Author(s):  
L.P. Shostakovych-Koretskaya ◽  
I.V. Budayeva ◽  
M.A. Nikolaichuk
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Multiple Organ ◽  
High Rate ◽  
Problem Presentation ◽  
The Central Nervous System ◽  
Progressive Course

Listeriosis is an infectious disease caused by Listeria monocytogenes microorganisms. A human can catch an infection through fecal-oral, aerogenous, or transplacental route. The listeriosis incidence in Ukraine is sporadic, single cases are not related to each other. Listeriosis is characterized by a high rate of mortality and polymorphism of clinical manifestations. The symptoms of the disease are multiple-organ: damage to the central nervous system, septic symptoms, aborts, mastitis; listeriosis can also be subclinical. The disorders of the central nervous system are associated with meningitis, meningoencephalitis, or brain abscess. The importance of the problem of diagnosis and treatment of listeriosis derived from the disease sporadicity, polymorphism of its manifestations, difficulties in etiological verification of the diagnosis. The case described is specific due to the diagnostic mistake: a child was not diagnosed with sepsis. Listeriosis in this child had a progressive course with sepsis development. Listeriosis is a rare infection, therefore it was difficult to suggest this particular infection intra vitam.

scholarly journals Cutaneous Ulcers as Initial Presentation of Localized Granulomatosis with Polyangiitis: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Noreen Nasir ◽  
Syed Ahsan Ali ◽  
Hafiz Mohammed Mehmood Riaz
Keyword(s):  
Respiratory Tract ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Granulomatous Inflammation ◽  
Organ Damage ◽  
Recurrent Fever ◽  
Small Vessel Vasculitis ◽  
Diagnostic Challenge ◽  
Extensive Evaluation ◽  
Atypical Manifestations

Background. Granulomatosis with polyangiitis (GPA) is an ANCA associated small vessel vasculitis characterized by necrotizing granulomatous inflammation involving the upper and the lower respiratory tract and the kidneys. The disease has a broad clinical spectrum that ranges from limited/localized involvement of a single organ system to a generalized systemic vasculitis that affects several organs with evidence of end organ damage. Atypical forms of the disease have been recognized with or without respiratory tract involvement with a long protracted course before manifesting as generalized disease.Case Presentation. We describe a 57-year-old woman who presented with recurrent fever and cutaneous ulcers on her legs who was diagnosed to have granulomatosis with polyangiitis (GPA) after an extensive evaluation which excluded infectious, other vasculitides, connective tissue disease and malignant etiologies.Conclusion. In the absence of typical manifestations, granulomatosis with polyangiitis (GPA) is indeed a diagnostic challenge to the physician. Atypical manifestations like unexplained recurrent fever and cutaneous ulcers nevertheless call for keeping a low threshold for the diagnosis of GPA as the disease can initially present in localized form before heralding into a generalized disease.

scholarly journals Dermatologic manifestations of granulomatosis with polyangiitis: A case report and literature review

2019 ◽  
Vol 6 (4) ◽  
pp. 19
Author(s):  
Ashley Thomas ◽  
Nithya Krishnan ◽  
Nicole Vesely ◽  
Myint Thway ◽  
Rafik Jacob
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Clinical Signs ◽  
Granulomatous Inflammation ◽  
Signs And Symptoms ◽  
Organ Damage ◽  
Skin Lesions ◽  
African American Female ◽  
Cutaneous Manifestations ◽  
Serologic Testing

Granulomatosis with polyangiitis (GPA) is an ANCA-associated, systemic vasculitis of small and medium-sized blood vessels. GPA causes inflammation and destruction to the vessel wall and eventual tissue and organ damage. It classically affects the tissues and vasculature of the sinuses, lungs, and kidneys. The organ damage results in epistaxis, cough, hemoptysis, shortness of breath and/or even kidney failure. Cutaneous manifestations are rare, but have been reported. We discuss the case of a 27-year-old African American female who presented with skin lesions on her bilateral forearms and hands, several years after diagnosis and treatment for GPA. The lesions were isolated papules, located on bilateral elbows, palms, and the lateral edge of the 3rd digit on her left hand. The lesions were intensely pruritic and non-painful. A skin biopsy of the lesions showed neutrophilic and granulomatous inflammation with nuclear debris, a largely non-specific histopathologic finding. An extensive autoimmune work up revealed elevated c-ANCA/PR3-ANCA levels supporting a diagnosis of cutaneous GPA. GPA is diagnosed by a combination of clinical signs and symptoms, serologic testing, and histology from biopsy of affected organs. Patient’s who meet the criteria should be tested for anti-neutrophil cytoplasmic antibody (ANCA), specifically c-ANCA/PR3-ANCA. A positive ANCA is supportive for GPA diagnosis. However, a negative ANCA does not rule out disease. Patients with cutaneous findings suggestive of GPA and positive c-ANCA/PR3-ANCA serologic testing should be closely followed up, which will lead to overall better prognosis, improved health outcomes and reduced patient and health care expenses.

Clinical case of periostitis in pregnant women complicated by sepsis

2020 ◽  
pp. 61-63
Author(s):  
S. Sh. Kakvaeva ◽  
M. A. Magomedova ◽  
A. N. Dzhalilova
Keyword(s):  
Pregnant Woman ◽  
Multiple Organ Failure ◽  
Pregnant Women ◽  
Organ Failure ◽  
Clinical Case ◽  
Clinical Observation ◽  
Infectious Agent ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Number Of Patients

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.

Middle ear tuberculosis - clinical case

ORL ro ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 12-14
Author(s):  
A. Sandul ◽  
M. Buracovschi ◽  
N. Buracovschi
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Human Population ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Tuberculous Otitis Media ◽  
Type V

Tuberculosis is one of the oldest pathologies that affect human population, being a significant cause of morbidity/mortality in several countries. Middleear tuberculosis is a rare pathology, often misdiagnosed because of an atipic evolution, as a result leading to severe complications. This paper presents a case of tuberculous otitis media complicated with facial nerveparalysis House Brackmann type V in a patient who underwent multiple middleear surgeries before correct diagnosis was established.  

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