Eosinophilic fasciitis - Diagnosis

Laboratory studies:
peripheral-blood eosinophilia present in 61-83% of patients, the degree of eosinophilia is variable over time, even in the absence of specific therapy
-by raising polyclonal hypergammaglobulinemia is a characteristicof immunoglobulin G
-increased erythrocyte sedimentation rate is detected in 29-70% ofcases
creatinine-kinase levels are normal serum and aldolaza
rheumatoid factor and antinuclear antibodies, are occasionallypositive
-hematologic abnormalities associated with eosinophilic fasciitis:aplastic anemia, thrombocytopenia, hemolytic anemia, lymphoma,pernicious anemia, leukemia
serology for Borrelia, or polymerase chain reaction positive
metalloproteinase-1 may be a serological marker of disease activity.

Imaging Studies:
MRI is the test of choice. In areas affected by show fascialthickening, abnormal tissue intensity. Support the implementation of diagnosis, location of biopsy and monitoring response totreatment.
Histological examination inflammation, swelling, thickening andsclerosis are the fasceitei eosinophilic fascia. Items include acutedeep fascia infiltration with lymphocytes, plasma cells, eosinophilsand histiocite. Distribution of eosinophils in the fascia can be focaland close relationship with blood eosinophilia. In areas that are found deep infiltrated paniculum similar. As the diseaseprogresses, inflammatory changes are replaced with generalizedsclerosis and thickening of the fascia and adjacent tissues.Sclerosis may be dense collagen strips parallel to the fascia andseals hialinizat small fat cells trapped between them.
The differential diagnosis is made ​​with the following conditions:eosinophilia, eosinophilia-myalgia syndrome, linear scleroderma,morphea, regional fibrosis, scleroderma, systemic sclerosis, toxicoil syndrome.