usmlebuzz
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A 47 year old Indian physician with a history of asthma and allergic rhinitis was hospitalized with a two week history of a papulovesicular rash and a painful toe. During this time he had increasing shortness of breath, cough and wheezing. Review of systems was pertinent for extreme fatigue and weight loss. He denied fevers, chills or night sweats.
Physical examination revealed hemorrhagic purpura with a crusting rash on scalp, hands and scrotum. Expiratory wheezing was audible over both lung fields. There was a violaceous discoloration of the 2nd toe on his left foot . The peripheral pulses were intact. The physical examination was otherwise unremarkable.
Laboratory values : Hb 14.2g/dl; Hct 43.6%; WBC 14,200/m l with 66% neutrophils, 4% bands, 21% eosinophils, 8% lymphs and 1% monos. HCO3 was 34 mEq/L and creatinine 0.9mg/dl. Urinalysis was normal; Sedimentation rate - 50 and p-ANCA - 1:640. Diffuse peripheral alveolar infiltrates were seen on the chest X-ray film
what is the diagnosis?
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| meg
Forum Guru
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sounds like Wegener's granulomatosis.... :roll:
(lungs+vasculitis+joint pain+skin lesion...)
is it the right answer?
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| usmlebuzz
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 Try again meg you r on the right track ....................
the labs might give you a clue :-k
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| alice8
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Churg-Strauss Syndrome
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| meg
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thanks :shock:
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| usmlebuzz
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correct
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Churg Strauss has c-anca..... not p-anca!
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| meg
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They can have either, 70% have p-ANCA predominantly
http://www.emedicine.com/med/topic2926.htm
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| mjl1717
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Meg thx for the article 
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