Cytomegalovirus Infection Seen After Eosinophilic Granulomatosis With Polyangiitis – A Case Report

Yıl 2021, Cilt: 8 Sayı: 2, 391 - 394, 30.06.2021

Kezban Armagan , Özgül Soysal , Nurullah Akkoç

https://doi.org/10.34087/cbusbed.905088

Öz

Eosinophilic granulomatosis with polyangiitis (EGPA) also known as Churg- Strauss syndrome is a systemic small- and medium-vessel necrotizing vasculitis, characterized by extravascular granulomas, and eosinophilia. Treatment is primarily with corticosteroids and, for severe disease, addition of other immunosuppressive agents. Here, Here, we want to present a 57-year-old male patient who was diagnosed with EGPA and developed an opportunistic infection as the cause of hepatitis after treatment. Cytomegalovirus (CMV) is a common cause of opportunistic infection and can cause various symptoms and even mortality in immunocompromized patients. It is rarely cause of acute hepatitis. Opportunistic infections may cause vasculitis as well as reactivate after immunosuppressed treatments.

Anahtar Kelimeler

Eosinophilic granulomatosis with polyangiitis (EGPA), Cytomegalovirus, acute hepatitis

Destekleyen Kurum

NO

Proje Numarası

NO

Teşekkür

Thanks to all authors

Eosinofilik Granülomatoz Polyangiitis Sonrası Görülen Sitomegalovirus Enfeksiyonu - Olgu Sunumu

Öz

Churg-Strauss Sendromu olarak da bilinen eozinofilik granülomatozis polianjit (EGPA), ekstravasküler granülomlar ve eozinofili ile karakterize, küçük ve orta damarları tutan sistemik nekrotizan bir vaskülittir. Vaskülitin tedavisi esas olarak kortikosteroidlerle olur ve şiddetli hastalık tablosunda diğer immünosüpresif ajanlar eklenebilir. Burada, EGPA tanısı alan 57 yaşında bir erkek hastayı ve tedavi sonrası görülen hepatit nedeni olarak fırsatçı bir enfeksiyon gelişen olguyu sunmak istedik Cytomegalovirus (CMV), sık görülen fırsatçı enfeksiyon nedenidir ve bağışıklığı baskılanmış hastalarda çeşitli semptomlara ve hatta ölüme neden olabilir. Nadiren akut hepatite de neden olmaktadır Fırsatçı enfeksiyonlar, vaskülite neden olabildiği gibi immünsüprese tedaviler sonrası da reaktive olabilir.

Anahtar Kelimeler

Cytomegalovirus, Eozinofilik granülomatöz polianjitis (EGPA), akut hepatit

Proje Numarası

NO

Kaynakça

• Pagnoux, C, Guilpain, P, Guillevin, L, Churg-Strauss syndrome, Current Opinion in Rheumatology, 2007, 19, 1, 25-32.
• Comarmond, C, Pagnoux, C, Khellaf, M, Cordier, J.F, Hamidou, M, Viallard, J.F et al., Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): clinical characteristics and long-term followup of the 383 patients enrolled in the French Vasculitis Study Group cohort, Arthritis & Rheumatism, 2013, 65, 1, 270-281.
• Doherty, M, Bradfield, J.W, Polyarteritis nodosa associated with acute cytomegalovirus infection, Annals of the Rheumatic Diseases, 1981, 40, 4, 419-421.
• Abril, A, Calamia, K.T, Cohen, M.D, The Churg-Strauss syndrome (allergic granulomatous angiitis): review and update, Seminars in Arthritis Rheumatology, 2003, 33, 106-14.
• Conron, M, Beynon, H.L, Huw, L.C, Churg-strauss syndrome, Thorax, 2000, 55, 10, 870-877.
• Noth, I, Strek, M.E, Leff, A.R, Churg-Strauss syndrome, The Lancet, 2003, 361, 587-594. Cottin, V, Bel, E, Bottero, P, Dalhoff, K, Humbert, M, Lazor, R, et al., Revisiting the systemic vasculitis in eosinophilic granulomatosis with polyangiitis (Churg-Strauss): A study of 157 patients by the Groupe d'Etudes et de Recherche sur les Maladies Orphelines Pulmonaires and the European Respiratory Society Taskforce on eosinophilic granulomatosis with polyangiitis (Churg-Strauss). Autoimmunity Reviews, 2017, 16, 1, 1-9.
• Guillevin, L, Cohen, P, Gayraud, M, Lhote, F, Jarrousse, B, Casassus P, Churg-Strauss syndrome, Clinical study and long-term follow-up of 96 patients, Medicine (Baltimore), 1999, 78, 1, 26-37.
• Wechsler, M.E, Garpestad, E, Flier, S.R, Kocher, O, Weiland, D.A, Polito, A.J, et al., Pulmonary infiltrates, eosinophilia, and cardiomyopathy following corticosteroid withdrawal in patients with asthma receiving zafirlukast, JAMA, 1998, 279, 6, 455-457.
• Della Rossa, A, Baldini, C, Tavoni, A, Tognetti, A, Neglia, D, Sambuceti, G et al., Churg–Strauss syndrome: clinical and serological features of 19 patients from a single Italian centre, Rheumatology, 2002, 41, 11, 1286-1294.
• Masi, A.T, Hunder, G.G, Lie, J.T, Michel, B.A, Bloch, D.A, Arend, W.P, et al, The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis), Arthritis & Rheumatism, 1990, 33, 8, 1094-1100.
• Guillevin, L, Pagnoux, C, Seror, R, Mahr, A, Mouthon, L, Le Toumelin, P, et al., The Five-Factor Score revisited: assessment of prognoses of systemic necrotizing vasculitides based on the French Vasculitis Study Group (FVSG) cohort, Medicine, 2011, 90, 1, 19-27.
• Sablé-Fourtassou, R, Cohen, P, Mahr, A, Pagnoux, C, Mouthon, L, Jayne, D, et al., Antineutrophil cytoplasmic antibodies and the Churg-Strauss syndrome, Annals of Internal Medicine, 2005, 143, 9, 632-638.
• Staras, S.A, Dollard, S.C, Radford, K.W, Flanders, W.D, Pass, R.F, Cannon, M.J, Seroprevalence of cytomegalovirus infection in the United States, 1988–1994, Clinical Infectious Diseases, 2006, 43, 9, 1143-1151.
• Nolan, N. Halai, U. A, Regunath, H, Smith, L, Rojas-Moreno, C, Salzer, W, Primary cytomegalovirus infection in immunocompetent adults in the United States–A case series, ID Cases, 2017, 10, 123-126.