The article presents a brief review of literature which shows the characteristic of bronchopulmonary and cardiovascular diseases that most often cause secondary absolute hypoxic erythrocytosis. The information about pathogenesis of blood changes at this nosology is given. The principles of differential diagnosis between secondary absolute hypoxic erythrocytosis and chronic myeloproliferative diseases, i.e. polycythemia vera and idiopathic myelofibrosis in erythremia stage are set. As an example three clinical cases of personal experience of the authors are given: 1) the patient who developed hypoxic erythrocytosis against chronic pulmonary heart disease formed due to a combination of COPD and Pickwick syndrome and "sleep apnea"; 2) the patient admitted to hospital initially only in connection with changes in the blood (erythrocytosis) for differential diagnosis and who was revealed to have arteriovenous malformation of the lung vessels; 3) the case of primary pulmonary hypertension diagnosis in a young patient with multiple comorbidities.
A brief review of the literature devoted to the rare eosin-filed granulomatous necrotizing vasculitis ChurgStrauss syndrome is given. Two clinical cases of this disease are presented from the personal practice of the authors. The complexity of diagnostics was emphasized; it contributed to the fact that the disease lasted for a long time under the guise of other nosologies which later turned out to be syndromes of vasculitis ChurgStrauss. When pulmonary infiltrates occur in patients with asthma with allergic rhinitis or rhinosinusopathy in combination with high eosinophilia of peripheral blood and neurologic symptoms, it is necessary to suspect the Churg-Strauss syndrome and conduct appropriate diagnostic measures.
The publication provides an overview of the literature devoted to modern methods of diagnosis of malignant pleural mesothelioma (MPM). The analysis of medical records of 14 MPM patients who were treated in the Amur regional clinical hospital in 2009-2014 was done. One case is dealt with in detail. Difficulties in diagnosing MPM happen due to the following factors: the early symptoms of this tumor are not specific, and patients often seek help in the advanced stages; the difficulty of differentiation between benign diseases of the pleura and metastasis of other tumors in the pleura; not full availability of computed tomography (CT) and a VATS biopsy; insufficient awareness of primary care physicians about the features of MPM course. To improve the diagnosis of MPM it is recommended to perform CT of the chest as the primary method of diagnosis in individuals of 50 years old, especially in those exposed to asbestos in the past.
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