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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1411- 19 November Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Case History: 71/M with a 4 year history of intermittent necrotic and purpuric blisters on extremities and increasing dyspnoea.

Case posted by Dr Arti Bakshi


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Guest Romualdo

Posted

Granulomatosis with polyangiitis (Wegener granulomatosis).

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Raul Perret

Posted

I was thinking of eosinophilic granulomatosis with polyangiitis [font=sans-serif][color=#252525](Churg-Strauss) but Wegener's comes to the differential too. CPC needed favor Churg Strauss[/color][/font]

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Small vessel vasculitis rich in eosinophils. The clinical picture of dyspnoea makes me think about Churg-Strauss and Wegener, but the infiltrate rich in eosinophils and the 4 years living with this disease favors Churg Strauss. History of asthma and blood eosinophilia may help.

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Dr. Mona Abdel-Halim

Posted

Allergic granulomatosis (Churg Strauss)

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[color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4]Churg-Strauss.[/size][/font][/color]

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Arti Bakshi

Posted

Yes, this is a case of Churg Strauss (better termed as Eosinophilic granulomatosis with polyangiitis).
Following the suggestion of Churg Strauss on the skin biopsy, he was referred to respiratory physicians who diagnosed him as late onset asthma and further investigations revealed myocarditis thought to be due to cardiac vasculitis.
ANCA was negative in the patient and apparently, the ANCA negative group (60%) is more likely to show cardiac involvement as opposed to ANCA positive group which more commonly shows renal and neurological involvement.

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