Kobayashi Tomoki, Kanno Keishi, Kikuchi Yuka, Kakimoto Masaki, Kawahara Akihiro, Kimura Kazuki, Ishida Ryoko, Miyamori Daisuke, Otani Yuichiro, Kishikawa Nobusuke, Tazuma Susumu
Department of General Internal Medicine, Hiroshima University Hospital, Japan.
Department of Community Based Medical System, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan.
Intern Med. 2019 Mar 15;58(6):871-875. doi: 10.2169/internalmedicine.1167-18. Epub 2018 Nov 19.
A 78-year-old woman with fever of unknown origin that had persisted for 3 months, systemic edema, and cervical lymphadenopathy was admitted to our hospital. Skin purpura and jaw claudication were subsequently observed. Histopathological examinations of the lymph nodes, skin, and temporal artery revealed findings characteristic of eosinophilic granulomatosis with polyangiitis (EGPA). However, she had no past medical history of asthma with modest eosinophilia. Although EGPA is a systemic vasculitis characterized by asthma and eosinophilia, various limited forms have been described. This was therefore considered to be an atypical form of non-asthmatic EGPA complicating with temporal arteritis (TA) diagnosed by tissue biopsy.
一名78岁女性因持续3个月的不明原因发热、全身性水肿和颈部淋巴结肿大入住我院。随后观察到皮肤紫癜和颌部跛行。淋巴结、皮肤和颞动脉的组织病理学检查显示具有嗜酸性肉芽肿性多血管炎(EGPA)的特征性表现。然而,她既往无哮喘伴轻度嗜酸性粒细胞增多病史。虽然EGPA是一种以哮喘和嗜酸性粒细胞增多为特征的全身性血管炎,但也有各种局限性形式的描述。因此,这被认为是一种非哮喘型EGPA的非典型形式,并伴有经组织活检诊断的颞动脉炎(TA)。