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Inicio Revista Colombiana de Reumatología Temporal arteritis caused by eosinophilic vasculitis associated with a lymphocyt...
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Vol. 31. Issue 2.
Pages 252-258 (April - June 2024)
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Vol. 31. Issue 2.
Pages 252-258 (April - June 2024)
Case Report
Temporal arteritis caused by eosinophilic vasculitis associated with a lymphocytic variant of the hypereosinophilic syndrome: A case report
Arteritis temporal por vasculitis eosinofílica asociada con una variante linfocítica del síndrome hipereosinofílico: reporte de un caso
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Roberto Benavidesa,b, Andrés Felipe Ramírez-Peraltac, Marcela Muñoz-Urbanoc, Leonardo Mejíad, Andrés Felipe Cardona-Cardonac,
Corresponding author
andrescardonaafc@gmail.com

Corresponding author.
, Carlos Horacio Muñoz-Vahosc,e,f
a Department of Internal Medicine, Universidad de Antioquia, Medellin, Colombia
b Department of Internal Medicine, Hospital San Vicente Fundación, Medellin, Colombia
c Rheumatology Section, Department of Internal Medicine, Universidad de Antioquia, Medellin, Colombia
d Hematology Section, Department of Internal Medicine, Hospital Pablo Tobón Uribe, Medellin, Colombia
e Rheumatology Section, Department of Internal Medicine, Hospital San Vicente Fundación, Medellin, Colombia
f Rheumatology Section, Department of Internal Medicine, IPS Universitaria Clínica León XIII, Medellin, Colombia
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Table 1. Laboratory data.
Abstract

Temporal arteritis in patients under the age of 50 years is an unusual form of vasculitis with a group of aetiologies that include rheumatological and hematological diseases. Additionally, vasculitis mimickers should be excluded. We describe a case of temporal arteritis due to eosinophilic vasculitis in a 36-year-old woman, associated with a lymphocytic-variant of hypereosinophilic syndrome. She presented facial and neck swelling, pruritic hive-like lesions, subtle thickening in the left temporal artery, headache, visual alterations, mandibular claudication, and hypereosinophilia. The temporal artery biopsy confirmed panmural eosinophilic vasculitis, and peripheral blood and bone marrow flow cytometry revealed T lymphocytes with aberrant immunophenotype (CD3CD4+). This case report describes the clinical features, histology, and treatment of temporal arteritis in young patients and hypereosinophilic syndrome, as well as clues for their differential diagnosis.

Keywords:
Hypereosinophilic syndrome
Eosinophilia
Temporal arteries
T-lymphocyte subsets
Systemic vasculitis
Resumen

La arteritis temporal en pacientes menores de 50 años es una forma inusual de vasculitis con un grupo de etiologías que incluyen enfermedades reumatológicas y hematológicas. Adicionalmente, se deben descartar imitadores de vasculitis. Se presenta el caso de una mujer de 36 años con arteritis temporal por vasculitis eosinofílica, asociada con una variante linfocítica del síndrome hipereosinofílico. La paciente presentó edema facial y cervical, lesiones urticariales pruriginosas, sutil engrosamiento de la arteria temporal izquierda, cefalea, alteraciones visuales, claudicación mandibular e hipereosinofilia. La biopsia de la arteria temporal evidenció una vasculitis eosinofílica panmural, en tanto que la citometría de flujo en sangre periférica y médula ósea reveló linfocitos T con inmunofenotipo aberrante (CD3CD4+). En este reporte de caso se describen las manifestaciones clínicas, histológicas y el tratamiento de la arteritis temporal en pacientes jóvenes y del síndrome hipereosinofílico, además de aportar pistas para su diagnóstico diferencial.

Palabras clave:
Síndrome hipereosinofílico
Eosinofilia
Arterias temporales
Subgrupos de linfocitos T
Vasculitis sistémica

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