RESUMO
BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare form of anti-neutrophil cytoplasmic antibody-associated vasculitis characterized by asthma, vasculitis, and eosinophilia. CASE SUMMARY: We report an atypical case of EGPA in a 20-year-old female patient. Unlike previously reported cases of EGPA, this patient's initial symptom was asthma associated with a respiratory infection. This was followed by Loeffler endocarditis and cardiac insufficiency. She received treatment with methylprednisolone sodium succinate, low molecular weight heparin, recombinant human brain natriuretic peptide, furosemide, cefoperazone sodium/sulbactam sodium, and acyclovir. Despite prophylactic anticoagulation, she developed a large right ventricular thrombus. EGPA diagnosis was confirmed based on ancillary test results and specialty consultations. Subsequent treatment included mycophenolate mofetil. Her overall condition improved significantly after treatment, as evidenced by decreased peripheral blood eosinophils and cardiac markers. She was discharged after 17 d. Her most recent follow-up showed normal peripheral blood eosinophil levels, restored cardiac function, and a reduced cardiac mural thrombus size. CONCLUSION: This case illustrates the swift progression of EGPA and underscores the significance of early detection and immediate intervention to ensure a favorable prognosis.
RESUMO
OBJECTIVE: The chest CT findings of the pneumonia patients with coronavirus disease 19 (COVID-19) were summarized to provide an auxiliary diagnostic basis for the early detection of infected patients. METHODS: Clinical data and CT images of 23 patients diagnosed with COVID-19 in West China Hospital of Sichuan University were retrospectively collected, and the chest CT findings were summarized and analyzed. RESULT: Of the 23 patients, 56.5% (13/23) had bilateral disease, 69.6% (16/23) had lesions distributed along the bronchovascular bundle, 65.2% (15/23) had lesions distributed periphery, 82.6% (19/23) involved in the basal segment of lower lobe, 82.6% (19/23) had ground-glass opacities, 30.4% (7/23) had ground-glass opacities with consolidation, 26.1% (6/23) had reticular changes. In the stage of disease progression, 54.6% (6/11) had an increased number of lesions, and 63.6% (7/11) had the scope of lesions enlarged and density increased. In the remission stage, 25.0% (4/16) had reduced number of lesions, 81.3% (13/16) had scope of lesions reduced, 62.5% (10/16) had density of lesions decreased, and 37.5% (6/16) had fibrosis. CONCLUSIONS: As an important diagnostic examination method for COVID-19, CT is conducive to the rapid diagnosis of the disease in patients with epidemiological history.
