1/6. Eosinophilic fasciitis after allogeneic stem cell transplantation: a case report and review of the literature.We present a 35-year-old male with acute myeloblastic leukemia who underwent allogeneic stem cell transplantation (AlloSCT) from his sibling. He developed acute swelling and tenderness in his extremities with eosinophilia 1 year after AlloSCT following 4 weeks of strenuous physical activity. At that time the leukemia was in complete remission and he had no evidence of chronic graft vs. host disease (cGVHD). His clinical picture and histological appearance of a full thickness skin biopsy were compatible with eosinophilic fasciitis (EF). He received prednisone and responded. Since signs and symptoms of EF can overlap with cGVHD and cause confusion, the careful examination of a skin/muscle/fascia biopsy can distinguish EF from cGVHD. For EF, corticosteroids appear to be the treatment of choice.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/6. ketotifen--a therapeutic agent of eosinophilic fasciitis?A 30-year-old male with eosinophilic fasciitis (EF) associated with morphoea and vitiligo is described. The patient showed a partial response to prednisone, but did not respond to hydroxychloroquine, D-penicillamine and cimetidine. In the light of reports of increased plasma histamine levels, and a putative role of mast cells in the pathogenesis of EF, ketotifen (a mast cell stabilizer) was prescribed. This non-toxic drug has allowed the patient to continue hard physical labour without further relapses and without corticosteroid therapy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/6. A 55-year-old woman with muscle pain and eosinophilia.We present the case of a 55-year-old female with three months of severe, diffuse muscle aching and pain. She had recently undergone orthopedic surgery, but had otherwise not noticed any changes to her baseline health. Her physical examination demonstrated only diffuse muscle tenderness and post-surgical changes to her right knee. Her laboratory evaluation was notable for plasma eosinophilia. An extensive rheumatological workup revealed no evidence of an underlying connective tissue disease. After undergoing a diagnostic procedure, the patient enjoyed a dramatic response to therapy for this disease. This disorder often has subtle clinical manifestations and is associated with vague systoms that can confound an accurate diagnosis.- - - - - - - - - - ranking = 15.560101311522keywords = physical examination, physical (Clic here for more details about this article) |
4/6. Clostridial sepsis: unusual clinical presentations.We present four cases exhibiting the widely diverse nature of clinical infections due to anaerobic clostridium perfringens. These cases exemplify the need for a thorough initial physical examination, immediate Gram staining of fluid from involved tissue, and recognition of the severity of the disease in any patient who has early septic deterioration after elective or emergency surgical procedures. Management of these infections includes both high-dose parenteral penicillin therapy and aggressive initial surgical debridement of all involved tissues.- - - - - - - - - - ranking = 15.560101311522keywords = physical examination, physical (Clic here for more details about this article) |
5/6. Eosinophilic fasciitis, reactive hepatitis, and splenomegaly.Eosinophilic fasciitis (EF) is an acute, idiopathic inflammatory disorder often manifested by tender swelling of the extremities after extreme physical exertion. It is usually without visceral complications. I treated a 25-year-old man with EF who had reactive hepatitis and splenomegaly. To my knowledge, the former has never been reported and the latter only once.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/6. rehabilitation of eosinophilic fasciitis. A case report.Eosinophilic fasciitis (EF), first described in 1974, is characterized by the sudden onset of painful swelling with induration of the soft tissues and peripheral eosinophilia, often after an episode of intense physical exertion. It rapidly progresses to joint contractures because of inflammation and fibrosis of the fascia. Of the 200 cases reported in the medical literature, most have responded positively to a prolonged course of oral prednisone. Although complete recovery is possible, more frequently signs and symptoms of EF persist. There were no detailed descriptions found in the literature of any rehabilitative interventions in this disease. This case study describes the methods used in a successful, comprehensive rehabilitation treatment of a 21-yr-old man admitted to the Palo Alto VA Medical Center rehabilitation program 8 mo after the onset of symptoms. Previous medication therapy included prednisone and methotrexate. The patient underwent 2 mo of inpatient rehabilitation, which consisted of upper and lower extremity nerve blocks, serial splinting, application of physical modalities, massage, stretching and strengthening exercises and interdisciplinary pain management. Significant improvement was made in the range of motion in all extremities, strength, hand function, level of pain, gait and endurance. Aggressive therapy did not increase eosinophilia. In fact the eosinophil count returned to normal by the time of discharge. A detailed review of the patient's rehabilitation program is presented.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |