Sandoval-De la Fuente A, Rodríguez-Martínez JJ

Language: Spanish
References: 9
Page: 272-276
PDF size: 246.43 Kb.

ABSTRACT

Background: Eosinophilic angiocentric fibrosis has an unknown aetiology, although trauma and a history of allergy are closely related. It is currently classified in the spectrum of manifestations of IgG4-related disease, a multisystem autoimmune disease.
Clinical cases: A female patient who, at the age of 23 years, presented with chronic nasal obstruction, initially attributed to septal deviation and allergic rhinitis. Septoplasty was performed, then medical management for allergic rhinitis was initiated. Years later, nasal obstruction returned, with the addition of hyposmia and hypogeusia, epistaxis was reported on several occasions, treated by cauterization with silver nitrate. Some time later, patient suffered blunt trauma to the nasal dorsum resulting in sinking of the nasal dorsum, for which she was operated on a second time, during this procedure a mass of diffuse fibrous tissue that infiltrated the nasal septum was described. Histopathological analysis reported eosinophilic angiocentric fibrosis. Clinical evolution continued with rhinosinusitis treated medically as well as with an endoscopic sinus surgery. Finally, the patient presented progressive sinking and widening of the nasal dorsum. A more aggressive surgical approach was performed with septectomy, frontoethmoidal endo- subscopic approach, resection of fibrous tissue from the nasal structure, and reconstruction by plastic surgery. Currently the patient is in the 4th decade of life and presents good functional and aesthetic evolution.
Conclusions: Despite eosinophilic angiocentric fibrosis is rare, we believe that knowledge of this disease can help identify new cases, since its indolent presentation and high chronicity can be a cause of underdiagnosis.

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