RESUMO
This report describes a 48-year-old man who presented with a month history of weakness and paraesthesia associated with severe pain of all four limbs. Initially diagnosed and treated as Guillain Barre syndrome due to the severity of his extremity weakness, it was later discovered to be eosinophilic granulomatous polyangiitis (EGPA). Mononeuritis multiplex should not be underestimated or overlooked in the setting of diagnosing EGPA and requires prompt treatment with biologics to limit the permanent consequences on patient's quality of life with regard to developing limb weakness and pain. Although peripheral neuropathy, namely, mononeuritis multiplex, is not the most common feature of EGPA, it is important to consider it in order not to delay treatment with biologic agents that as seen in our patient can both halt the progress of the disease as well as give the patient a better quality of life.
RESUMO
Giardia lamblia is a protozoan that results in the commonly diagnosed giardiasis. Due to its prevalence and incidence worldwide, it is essential to recognize the different presentations of giardiasis, routes of transmission, modalities of diagnosis, treatments, and complications. Diagnostic modalities have evolved over the years and can be achieved reliably through noninvasive stool testing. Endoscopic duodenal aspirate and biopsies can also be used; however, they yield lower sensitivity and specificity rates and are therefore not used as a first-line modality for diagnosing giardiasis. Nonetheless, its use should be considered in cases with high suspicion and unremarkable stool testing. Herein, we discuss the case of a 27-year-old male with chronic weight loss and abdominal pain for six months diagnosed with G. lamblia through a duodenal biopsy.