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Old 12-28-2011
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Question Asthma, Rhinitis, Abdominal Pain, and Eosinophilia!

A 35-year-old man with a history of rhinitis and asthma presents to his physician with complaints of intermittent severe abdominal pain and a chronic maculopapular rash. Peripheral blood smear demonstrates a marked eosinophilia. Biopsy of a skin lesion demonstrates necrotizing vasculitis with large numbers of eosinophils. Which of the following diagnoses is most likely?

A. Churg-Strauss syndrome
B. Leukocytoclastic angiitis
C. Mnckeberg's arteriosclerosis
D. Temporal arteritis
E. Wegener's granulomatosis
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Old 12-28-2011
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A. Churg-Strauss syndrome
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Old 12-28-2011
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Churg strauss syndrome
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Old 12-28-2011
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A. Churg-Strauss syndrome
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Default it's A

I second all of the above - it's A
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A. Churg-Strauss syndrome
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Default A

A. Churg-Strauss syndrome
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Old 12-29-2011
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The answer is A.

The most likely condition is Churg-Strauss syndrome, also known as allergic granulomatosis and angiitis. This variant of polyarteritis nodosa is clinically associated with asthma and eosinophilia. The vascular lesions are those described in the question stem. Granulomas are present in many, but not all, cases. Pulmonary involvement may be prominent, but this is not always the case. In this case, the patient's abdominal pain is related to GI vasculitis, and his skin rash is related to dermal vasculitis. Churg-Strauss syndrome should be suspected in any patient with vasculitic symptoms, eosinophilia, and asthma.
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