Clinical expert case of eosinophilic granulomatous vasculitis

Abstract

The article is an example of individual approach to medical-social examination (MSE) of the patient with eosinophilic granulomatous with polyangiitis (EGPA) that represents the difficulty in the absence of a strictly regulated order of the criteria in systemic vasculitis. Implications of illness at the patient were presented by bronchial asthma, a bilateral hydrothorax, pericarditis, displays of polyneuropathy, and eosinophilia. Therapy by Prednisolonum of 40 mg in within a year has not allowed to achieve reduction of process activity. The hydrothorax recurred. There were signs of central nervous system impairment; the psychiatrist diagnosed organic emotional and labile disorder of vascular genesis with moderate emotional-volitional and mnestic-intellectual decrease. When conducting MSE there were difficulties at quantitative assessment of disturbances, due to the lack of EGPA in the annex to the existing order. Therefore, the decision to establish the second group of disability has been made by specialists of MSE bureau. As the patient suffers from recurrent hydrothorax, a pulmonitis, persistent obstruction of bronchi of average degree of expression, the anoxemia that is indirectly determined by depression of a saturation of oxygen to 94 %, expressed respiration dysfunction (70 %) has been established, as well as impairment of CNS and the peripheral nervous system. The forecast for convalescence is adverse. The forecast for life - rather favorable, because the heart and kidneys are not affected.

Keywords

• eosinophilic granulomatosis with polyangiitis
• medical and social assessment
• disability