EOSINOPHILIC FASCITIS: CLINICAL, RADIOLOGICAL AND HISTOLOGICAL CORRELATIONS

Golovach I.Yu. ¹, Chipko T.M. ¹, Dyadyk O.O. ², Mychalchenko O.M. ¹, Udovichenko K.O. ¹, Vershynina D.V.³, Lazorenko O.O.¹

• ¹Feofania Clinical Hospital of the State Directorate for Affairs, Kyiv
• ²National University of Health Care of Ukraine named after P.L. Shupyka
• ³Precarpathian Diagnostic Center “Euroclinic”, Ivano-Frankivsk

Summary. Introduction. Diffuse eosinophilic fasciitis (DEF) is a rare rheumatic disorder of unknown etiology and poorly understood pathogenesis. Eosinophilic fasciitis is a disease originally proposed as «diffuse fasciitis with eosinophilia» by Shulman in 1974. The patients with this disease often have history of strenuous exercise or labor a few days to 1–2 weeks before the onset. The chief symptoms are symmetrical, full-circumference swelling and plate-like hardness of the distal limbs. Purpose of the study. We present a description of a clinical case of diffuse eosinophilic fasciitis in a 44-year-old man. Results. In this case, the starting point for the development of the disease was excessive physical activity. Eosinophilia was observed once and is no longer registered. Hypergammaglobulinemia was noted. The clinical picture was dominated by skin symptoms (skin thickening), with the formation of a typical «groove» symptom, movement restriction, weight loss, and a fever syndrome that occurred after exercise. The results of an MRI study of the calf muscles are presented, as well as pathohistological data with enzyme immunoassay, which made it possible to make a diagnosis of diffuse eosinophilic fasciitis. Conclusion. The diagnosis was established on the basis of a typical clinical picture, exclusion of other rheumatic diseases, confirmed by MRI and histopathological/immunochemical studies.