| E31 / Vnitř Lék 2022;68(2):E29-E31 / VNITŘNÍ LÉKAŘSTVÍ www.casopisvnitrnilekarstvi.cz KAZUISTIKY Rare cause of spontaneous spleen bleeding: a case report and literature review and affects small or medium-size vessels of any organs (7). Together with Wegener’s granulomatosis and microscopic polyangiitis belong to vasculitis associated with the presence of antineutrophil cytoplasmatic autoantibodies (ANCA) (8). According to available papers, traces of ANCA antibodies have been found in 40-75%of patients. Estimated incidence is approximately 2,5 cases per 100 000 adults per year. The average age of patient is 50 years (9). Diagnosis can be difficult. The American College of Rheumatology suggested six criteria for diagnosis Churg-Strauss syndrome: presence of asthma, eosinophilia of more than 10 % in peripheral blood, paranasal polyps or sinusitis, pulmonary infiltrates, histological proof of vasculitis with extravascular eosinophils and mononeuritis multiplex (or polyneuropathy) (10). The prognosis depends on the start of the treatment. Without treatment, 5-year survival rate of patients is about 25% (11). The disease is obscure, with minimal symptoms and a variable clinical picture. Spleen involvement is rare and usually presents as splenic infarction. There is no reported case of asymptomatic splenic rupture associated with Churg-Strauss disease. Conclusion Spontaneous spleen rupture is an extremely rare condition and usually is not considered in the differential diagnosis of acute abdominal pain. In this report, we presented a clinical case of spontaneous spleen rupture in a patient with unknown Churg-Strauss disease, as a first manifestation of disease. This study was supported by Ministry of Health of the Slovak Republic under the project registration number 2019/44-UKMT-7 REFERENCES 1. Tunçyürek Ö, Tunçyürek P, Ertekin E et al. Pathological rupture of the normal spleen: Review with the literature. Int J Surg Case Rep. 2016;26:163-5. doi: 10.1016/j.ijscr.2016.07.029. Epub 2016 Jul 28. PMID: 27497938; PMCID: PMC4975709. 2. Wehbe E, Raffi S, Osborne D. Spontaneous splenic rupture precipitated by cough: a case report and a review of the literature. Scand J Gastroenterol. 2008;43(5):634-7. doi: 10.1080/00365520701763472. PMID: 18415760. 3. Abbadi SE, Rhouni FZ, Jroundi L. Rupture spontané de la rate: à propos d’un cas et revue de la littérature [Spontaneous splenic rupture: about a case and review of the literature]. Pan Afr Med J. 2017;27:62. Published 2017 May 29. doi:10.11604/pamj.2017.27.62.12451. 4. BaibarsM, OhrumP, Alraiyes AH et al.Asymptomatic spleen rupture in patient with endocarditis, QJM: An International Journal of Medicine, Volume 106, Issue 11, November 2013, Pages 1047–1048, https://doi.org/10.1093/qjmed/hcs190. 5. Greco A, Rizzo MI, De Virgilio A et al. Churg-Strauss syndrome. Autoimmun Rev. 2015 Apr;14(4):341-8. doi: 10.1016/j.autrev.2014.12.004. Epub 2014 Dec 11. PMID: 25500434. 6. Nguyen Y, Guillevin L. Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss). Semin Respir Crit Care Med. 2018 Aug;39(4):471-481. doi: 10.1055/s-0038-1669454. Epub 2018 Nov 7. PMID: 30404114. 7. Keogh KA, Specks U. Churg-Strauss syndrome. Semin Respir Crit CareMed. 2006 Apr;27(2):14857. doi: 10.1055/s-2006-939518. PMID: 16612766. 8. Boyer D, Vargas SO, Slattery D et al. Churg-Strauss syndrome in children: a clinical and pathologic review. Pediatrics. 2006 Sep. 118(3):e914-20. 9. Masi AT, Hunder GG, Lie JT, et al., The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum. 1990 Aug. 33(8):1094-100. 10. Keogh KA, Specks U. Churg-Strauss syndrome: update on clinical, laboratory, and therapeutic aspects. Sarcoidosis Vasc Diffuse Lung Dis. 2006 Mar. 23(1):3-12. 11. Hattori N, Ichimura M, Nagamatsu M et al. Clinicopathological features of Churg–Strauss syndrome-associated neuropathy, Brain, Volume 122, Issue 3, March 1999, Pages 427–439, https://doi.org/10.1093/brain/122.3.427. MORAVSKOSLEZSKÉ pneumologické dny 30. 30. 9. 1. 10. 2022 CLARION CONGRESS HOTEL OLOMOUC PROGRAMOVÉ BLOKY ▪ Bronchiální obstrukce ▪ Bronchologie ▪ Cystická fibróza, bronchiektázie ▪ Farmakoterapie respiračních nemocí ▪ Hrudní chirurgie ▪ Intenzivní pneumologie ▪ Intersticiální plicní procesy ▪ Nemoci spánku ▪ Ošetřovatelská péče ▪ Pneumo 35 ▪ Pneumoonkologie ▪ Respirační fyzioterapie ▪ Respirační infekce ▪ Transplantace plic ▪ Tuberkulóza ▪ Varia ▪ Vyšetřovací metody ▪ Sesterská sekce ▪ Posterová sekce ODBORNÝ GARANT MUDr. Petr Jakubec, Ph.D. POŘADATEL Česká pneumologická a ftizeologická společnost ČLS JEP Zapojte se s aktivní účastí! Přihlášky k aktivní účasti zasílejte do 15. 6. 2022. On-line registrační formulář a pokyny naleznete na www.dnypneumologie.cz. Aktivní účastníci jsou osvobozeni od registračního poplatku. Více informací o akci naleznete na www.dnypneumologie.cz
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