摘要
Abstract
Objective Todiscussthediagnosisandtreatmentofeosinophilicgranulomatosiswith polyangiitis(EGPA)complicatedwithgangrene.Methods OnemalepatientofEGPAcomplicatedwithgan-grene was reported. Relevant literatures were searched in the MEDLINE,NCBI,CBM,CNKI,and WAN-FANG databases using the keywords of“EGPA”or “Churg-Strauss syndrome”or “allergic granulomatosis”combined with“gangrene”or“ischemia”. Clinical data of EGPA patients complicated with gangrene were re-viewed.Results Themalepatient,aged48years,presentedwithprolongedfever,rash,wanderingpulmona-ry infiltration complicated with pulmonary hemorrhage,submucosal cyst in maxillary sinus,deep venous throm-bosis in lower extremities,gangrene in the right index finger of right hand,lightning-like pain in the right arm, eosinophilia and thrombocytopenia in the recent 2 years. He was diagnosed with EGPA combined with gangrene and secondary antiphospholipid syndrome (APS). After 7-week therapy with high-dose glucocorticoid,cyclo-phosphamide and anticoagulant,gangrene in the index finger of right hand was recovered and other clinical manifestations were improved. According to literature review,4 cases with details of EGPA complicated with gangrene were reported aboard,2 had gangrene in single fingertip,1 had gangrene in multiple fingertips and 1 had foot gangrene. Two patients were successfully treated with glucocorticoid,immunosuppressant and anticoag-ulant,one was recovered after undergoing amputation surgery and another patient died from aggravated foot gan-grene.Conclusions EGPAcomplicatedwithgangreneisrarelyencounteredinclinicalsettings.Thepossibili-ty of inherited thrombophilia,APS and acquired thrombophilia should be excluded when the diagnosis is made.Due to poor prognosis for EGPA combined with gangrene,early intervention is urgently required.关键词
嗜酸性肉芽肿性多血管炎/坏疽/血栓Key words
Eosinophilicgranulomatosiswithpolyangiitis/Gangrene/Thrombosis
