A case of eosinophilic granulomatosis with polyangiitis associated with diffuse alveolar haemorrhage: A case report and case-based review

Rira Kawaguchi; Hirohisa Usagawa; Yoshia Miyawaki; Hiroshi Oiwa

doi:10.1093/mrcr/rxae019

A case of eosinophilic granulomatosis with polyangiitis associated with diffuse alveolar haemorrhage: A case report and case-based review

Mod Rheumatol Case Rep. 2024 Apr 27:rxae019. doi: 10.1093/mrcr/rxae019. Online ahead of print.

Authors

Rira Kawaguchi¹, Hirohisa Usagawa¹, Yoshia Miyawaki², Hiroshi Oiwa¹

Affiliations

¹ Department of Rheumatology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
² Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan.

PMID: 38676913
DOI: 10.1093/mrcr/rxae019

Abstract

A 76-year-old man with bronchial asthma was admitted for respiratory failure and bloody sputum. A significant drop in haemoglobin and multiple consolidations supported clinical diagnosis of diffuse alveolar haemorrhage (AH). Myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) was positive and urinalysis suggested glomerulonephritis. Based on eosinophilia, sinusitis, peripheral nerve involvement, and leukocytoclastic vasculitis, he was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA) associated with AH. Our case-based review suggested that male predominance (65%), high positivity for ANCA (88%) and a high frequency of renal involvement (45%) may be characteristic of AH in EGPA. Although AH is rare in EGPA, we should be aware of this life-threatening complication.

Keywords: Eosinophilic; alveolar haemorrhage; glomeruronephritis; granulomatosis with polyangiitis; leukocytoclastic vasculitis.

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