A 32-year-old woman with asthma, eosinophilia, and a sensorimotor neuropathy

Article Abstract:

The case history is presented of a 32-year-old woman, who was well until three years before she entered the hospital, at which time she developed asthma. Ten months prior to her admission she developed pneumonia, and four months later, hepatitis. These conditions appeared to have been successfully treated. The patient then experienced arthralgia (joint pain) in her shoulders, hips, and knees, and she had a high number of eosinophils (one type of white blood cell); these signs and symptoms also resolved. A short time later, edema, numbness and a burning sensation developed in the lower legs, ultimately becoming intensely painful. A neurological examination indicated that the patient had impaired sensation over both feet, and during her first few days in the hospital, the patient's leg pain became unbearable. The number of eosinophils was high. A symmetric rash was noted over the buttocks, backs of the arms, feet, and abdomen. Several types of medication were prescribed. After seven days, her condition had improved. The significance of neuropathy (nerve disease) with eosinophilia, usually associated with allergies or parasitic infestations, is discussed. The clinical diagnosis was neuropathy involving the lower extremities, with a possible vasculitis (inflammation of blood vessels). Another diagnosis was systemic vasculitis with asthma and eosinophilia, also known as the Churg-Strauss syndrome. Results from analyzing nerve and muscle biopsy specimens led to the pathologist's diagnosis of Churg-Strauss phenomenon, with necrotizing vasculitis (associated with tissue death) and chronic neuropathy of the sort associated with mononeuritis multiplex (inflammation of nerves in several areas of the body). The condition is treated with steroid drugs, and leads to death over a period of many years. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Physiological aspects, Churg-Strauss syndrome

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A 44-year-old woman with headache, blurred vision, and an intrasellar mass

Article Abstract:

A 44-year-old woman with blurred vision, headaches, hot flashes, and an enlargement at the base of her brain was found to have lymphocytic hypophysitis, an inflammation of the pituitary gland caused by accumulation of white blood cells. Magnetic resonance imaging and CT scans showed a mass adjacent to the pituitary gland pressing on her optic nerve. The patient also had depressed levels of pituitary hormone, thyroid hormone, adrenal hormone, and gonadotropin. A surgical procedure showed that the mass was not separated from the pituitary gland, which was swollen, yellow, and had fibrous. A biopsy of the gland revealed that the mass contained lymphocytes. A portion of pituitary was removed, relieving the pressure on the optic nerve. The patient's headaches were relieved and her vision returned, but her pituitary gland function did not resume. As a result she was treated with corticosteroids.

Hypopituitarism

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A 64-year-old woman with peripheral neuropathy, paraproteinemia, and lymphadenopathy

Article Abstract:

A 64-year-old woman with peripheral nerve disease was diagnosed with systemic amyloidosis. Amyloidosis is caused by deposits of a protein called amyloid in body tissues and organs.

Amyloidosis, Peripheral nerve diseases, Peripheral nervous system diseases

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