Efeitos diferenciais da terapêutica cortico/imunossupressora nas diversas manifestações da síndrome de Churg-Strauss: a propósito de um caso clínico
Palavras-chave:
Churg-Strauss, terapêutica imunossupressiva, envolvimento neurológico, resistência à terapêuticaResumo
Descreve-se o caso de uma doente de 64 anos, com asma
de aparecimento tardio, com 10 anos de evolução, que se
apresentou no serviço de urgência com um quadro de febre e
mononeuropatia múltipla grave, acompanhada de eosinofilia,
sendo estabelecido o diagnóstico de Síndrome de Churg-Strauss
(SCS). Foi instituída terapêutica imunossupressora (prednisona e
ciclofosfamida). A febre, a asma e a hipereosinofi lia regrediram
rapidamente, verifi cando-se resistência prolongada do quadro
neurológico, acompanhada de resposta inflamatória sistémica.
Esta dissociação é ilustrativa dos efeitos distintos da terapêutica
na expressão respiratória/eosinofílica do SCS e no quadro neurológico, provavelmente resultantes de mecanismos imunopatológicos diferentes destas duas componentes da síndrome.
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