A late diagnosis of eosinophilic granulomatosis with polyangiitis
Italian Journal of Medicine
; 16(SUPPL 1):71, 2022.
Article
in English
| EMBASE | ID: covidwho-1912982
ABSTRACT
Background:
Eosinophilic granulomatosis with polyangiitis (EGPA) is a medium and small vessel vasculitis.Discussion:
A 58-years man was admitted to the Emergency Department in January 2022 for myalgia and weakness of lower limbs in recent COVID-19 infection. He had a clinical history of allergic asthma and eosinophilic pneumonia (ANCA negative) diagnosed as secondary to sensitization work-related in 2001. Blood test showed a severe hypereosinophilia (absolute eosinophil count 9875/microL) and elevated creatine kinase (CK 7555 U/L). He was hospitalized in HUB COVID. During hospitalization reported paraesthesia of upper and lower limbs and fever;blood test showed elevation of inflammation markers. Autoimmune screening showed a antineutrophil cytoplasmic antibodies positivity (ANCA anti-MPO 178UI/mL). A sinus CT showed nasal polyposis. A neurological evaluation and electromyography were performed with the evidence of polyneuropathy. Muscle biopsy showed eosinophil-associated vascular occlusion and eosinophilassociated tissue damage. The investigation excluded renal, cardiac, pulmonary and gastro-intestinal involvement. A steroid therapy (Prednisone 1 mg/kg/die) was started with clinical improvement.Conclusions:
EGPA is a multisystemic disorder, typically suspected based on a combination of clinical findings, such as asthma, nasal and sinus symptoms, peripheral neuropathy, and eosinophilia ≥1500/microL. ANCA antibodies are positive in around 40% of patients and diagnosis can often be challenging and delayed.
creatine kinase; endogenous compound; neutrophil cytoplasmic antibody; prednisone; adult; allergic asthma; asthma; blood vessel occlusion; Churg Strauss syndrome; conference abstract; controlled study; coronavirus disease 2019; diagnosis; drug therapy; electromyography; emergency ward; eosinophil; eosinophil count; eosinophilia; fever; heart; hospitalization; human; human cell; hypereosinophilia; inflammation; kidney; Loeffler pneumonia; lower limb; male; muscle biopsy; myalgia; nose polyp; paranasal sinus; paresthesia; peripheral neuropathy; polyneuropathy; sensitization; small vessel vasculitis; steroid therapy; tissue injury; weakness
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Italian Journal of Medicine
Year:
2022
Document Type:
Article
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