Extensive eye-oral-bronchial mucosal nodules with eosinopgillia: a rare case report and literature review
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CASE REPORT
Open Access
Extensive eye-oral-bronchial mucosal nodules with eosinopgillia: a rare case report and literature review Lujin Wu1,2†, Qianru Leng1,2†, Yan Wang1,2, Daowen Wang1,2 and Danlei Yang3*
Abstract Background: Mucosal nodules can be caused by infection, inflammation and neoplastic disease. Many noninfectious diseases, such as eosinophilia, amyloidosis, sarcoidosis, Wegener’s granuloma, langerhans cell histiocytosis etc., are associated with the formation of multisytem mucosal nodules, especially significant bronchial lesions. Detailed medical history, comprehensive metabolic profile, biopsy specimen and imaging examinations are required for differentiating among these disorders. The process of diagnosis and treatment of our patient’s mucosal nodules was challenging, which could be helpful to similar cases. Case presentation: We represent a case of a 29-year-old woman with plentiful nodules of unknown origin on extensive mucous membranes. Biopsy specimen reports inflammatory lesions with large numbers of neutrophils, lymphocytes, and varying degrees of eosinophils. Treatment of anti-infection, anti-tussive and anti-allergic was ineffective, but glucocorticoid showed great improvement to her symptoms. Conclusion: We experienced a rare case with plentiful nodules of unknown origin on extensive mucous membranes. She may be a specific phenotype of eosinophilia or may be a novel multisystem disease with respiratory system as the primary symptom. The diagnosis of our patient remains unclear, but tentative glucocorticoid therapy was beneficial. Keywords: Mucosal nodules, Eosinophilia, Glucocorticoid, Case report
Background Rare diseases are conditions that affect a small proportion of the population; the definition of rare disease varies from country to country due to the influence of region and population base. In the USA they are described as affecting fewer than 200,000 people (https:// rarediseases.info.nih.gov), and in Europe as affecting fewer than one in 2000 (https://www.eurordis.org/aboutrare-diseases). In China, the incidence rate is defined as * Correspondence: [email protected] † Lujin Wu and Qianru Leng contributed equally to this work. 3 Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, People’s Republic of China Full list of author information is available at the end of the article
less than one in 10,000 newborns and less than one in 500,000 people [1]. There are many kinds of rare diseases of respiratory system, which are easy to be missed and misdiagnosed in clinic. Current reports include: langerhans cell histiocytosis, eosinophilia, pulmonary alveolar proteinosis (PAP), lymphangioleyomiomatosis (LAM), bronchial amyloidosis, Wegener’s granuloma, Kartagener syndrome, bronchial mucosal tuberculosis, osteomalacia, etc. [2–4]. We treated a patient with recurrent cough and expectoration, accompanying with multiple nodules in the oral mucosa and ophthalmic conjunctiva. Bronchosco
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