Churg Strauss Syndrome – Case Report

We report a 49 year old male patient who presented with swelling in both thighs without pain and dyspnea. Platelet count was low (13,000/mm3) with increased eosinophils (48.9%). Patient developed pulmonary embolism. His ADAMTS 13 level was low and was therefore diagnosed as TTP. Treatment given was corticosteroid and plasma exchange. After a year he developed a lump in the skull. Histopathology report revealed vasculitis. Due to presence of vasculitis (TTP) along with eosinophilia, patient was finally diagnosed as a case of Churg Strauss Syndrome (CSS)

Analysis of Therapeutic Phlebotomy in Patients of Polycythemia: A Single Center Study

Introduction: Polycythemia is increased red cell mass according to age and sex of the individual. It could be primary (Polycythemia Vera), or secondary, due to chronic hypoxia or increased erythropoietic drive. Polycythemia is managed with therapeutic phlebotomy along with treating the underlying cause if determined. Phlebotomy of one unit whole blood should result in fall of Hb of at least 1g/dl. This study was conducted to see the effect of phlebotomy on fall in Hb level.Different parameters which can affect Hb levels in polycythemia patients, like age, JAK-2 mutation status and underlying cause were also studied.Methodology: A cross sectional study was conducted at blood bank of Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad Pakistan January 2020 to December 2020. Data were collected from 121 patients of Polycythemia vera who reported in blood bank for phlebotomy.Results: The average pre phlebotomy hemoglobin of the patients was 17.45g/dl, which dropped to 15.97g/dl after phlebotomy. In total, 89 (73.5%) patients who underwent phlebotomy had a fall in Hb of greater than or equal to 1g/dl, while in 32 (26.4%) patients, Hb drop was less than 1g/dl. One hundred and five patients underwent multiple therapeutic phlebotomies to maintain their hemoglobin within normal range.Conclusion: This study has shown that there is fall in Hb as result of recommended phlebotomy leading to relief in symptoms due to Polycythemia. Phlebotomy is the basis of treating polycythemia, although in secondary polycythemia the underlying cause should also be diagnosed and treated