| PurposeImprove the understanding of Eosinophilic Granulomatosis with Polyangiities(EGPA)with thrombotic events,achieve early detection,early diagnosis,early treatment,and improve prognosis.MethodA patient with EGPA complicated with multiple thrombosis admitted to the Department of Rheumatology and Immunology,the First Hospital of Shanxi Medical University in December 2018 and collected "EGPA","Churg-Strauss syndrome(CSS)","Allergic granulomatous vasculitis(AGPA)",and "thrombosis","Ischemia","infarction" are search terms,search for Pubmed and Google databases abroad,and China Knowledge Network,Wanfang,The database searches for relevant literature since the establishment of the library,and summarizes the literature and case data that meet the screening criteria,and analyzes its clinical manifestations,organ involvement,laboratory tests,case performance,thrombus type,diagnosis and treatment plan,and follow-up,retrospective analysis.Result(1)A total of 64 cases that met the screening criteria at home and abroad were retrieved,and 72 patients were reported.In conjunction with this example,a total of73 patients with EGPA combined with thrombotic events.Of the 73 patients,42 were male and 31 were female,with a male to female ratio of 1.35:1 and an average age of45.5 ± 19.1 years.(2)In the time series of EGPA diagnosis and thrombotic events,both(64/73,87.7%),(9/73,12.3%)had thrombotic events after EGPA diagnosis.(3)Clinical manifestations were most common in respiratory system(50 cases,68.49%),followed by skin(29 cases,39.73%),cardiovascular system(25 cases,34.25%),systemic symptoms(25 cases,34.25%)The nervous system(23 cases,31.51%),eyes(19 cases,26.03%),digestive system(15 cases,20.55%)and urinary system(3 cases,4.11%).(4)Of the 73 patients with EGPA with thrombotic events,venous thrombosis(37cases,50.7%),arterial thrombosis(30 cases,41.1%),mixed thrombus(6 cases,8.2%).(5)A total of 101 thrombotic events occurred,including venous thrombosis(59,39.73%),mainly with deep venous thrombosis(14 cases,14.86%),pulmonary embolism(9 cases,8.91%);arterial thrombosis events(42 For example,20.79%),mainly central/brachial arteries(13 cases,12.87%),cerebral arteries(10 cases,9.90%),myocardial infarction/coronary thrombosis(9 cases,8.91%).(6)In the laboratory examination,eosinophilia(57/73 cases,83.56%),ANCA negative(32/49 cases,78.05%),ESR increased(26/39 cases,66.67%),CRP rise High(17/32 cases,56.67%).(7)Pathological types include eosinophil infiltration(41/50 cases,82.00%)vasculitis changes(5/50 cases,10%),granuloma formation(2/50 cases,4.00%),eosinophils Cell infiltration and vasculitis were changed(2//50 cases,4.00%).(8)Evaluation of prognosis FFS score ? 2(10 cases,13.70%),1 point(41 cases,56.16%)and 0 points(22 cases,30.14%).(9)Glucocorticoid combined immunosuppressive agents(including cyclophosphamide,azathioprine)were the most commonly used treatments(24/67 cases,35.82%),followed by(17/67 cases,25.37%)sugar Corticosteroid combined immunosuppressive agents and anticoagulant/thrombotic drugs,(14/67 cases,20.89%)were glucocorticoids combined with anticoagulant/thrombotic drugs,while(12/67 cases,17.91%)only used glucocorticoids.Hormone,the prognosis is generally good.ConclusionArteriovenous thrombosis in EGPA patients can occur at any age,more common in young and middle-aged men.Among the thrombus types,venous thrombosis is common(physical deep vein thrombosis),followed by arterial thrombosis(retinal arterial thrombosis).It is prone to respiratory,cardiovascular and nervous system involvement in many clinical organs.The test is mostly negative for ANCA and peripheral.Blood Eos,CRP increased.Treatment with glucocorticoid combined with immunosuppressive therapy,anticoagulation / thrombolysis,the prognosis is generally good. |
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