Mahmood Khalid, Butt Nauman Ismat, Ashfaq Fahmina, Aftab Sabeen
Khalid Mahmood, MBBS, FCPS. Assistant Professor, Department of Medicine & Allied, Azra Naheed Medial College, Superior University, Lahore, Pakistan.
Nauman Ismat Butt, MBBS, FCPS. Assistant Professor, Department of Medicine & Allied, Azra Naheed Medial College, Superior University, Lahore, Pakistan.
Pak J Med Sci. 2023 Jan-Feb;39(1):307-309. doi: 10.12669/pjms.39.1.6436.
A 72-year-old asthmatic gentleman with a history of recurrent sinusitis and chronic bronchitis presented with shortness of breath and progressively worsening hypoxemic respiratory failure. His CT chest demonstrated airspace disease bilaterally with ground-glass opacifications. He had peripheral eosinophilia with raised inflammatory markers but negative work up of infection. On further investigation, ANA was positive, titer 1:160, speckled pattern and both pANCA and cANCA were present. The patient was diagnosed with Eosinophilic Granulomatosis with Polyangiitis (EGPA) and started on intravenous steroids and cyclophosphamide. A rare multi-organ vasculitis, EGPA is hallmarked by asthma, sinusitis and eosinophilia. In initial stages vasculitic involvement is not usually seen thereby making EGPA a diagnostic challenge.
一位72岁的哮喘男性患者，有复发性鼻窦炎和慢性支气管炎病史，出现呼吸急促和进行性加重的低氧性呼吸衰竭。他的胸部CT显示双侧气腔病变伴磨玻璃影。他有外周血嗜酸性粒细胞增多及炎症指标升高，但感染相关检查结果为阴性。进一步检查发现，抗核抗体（ANA）阳性，滴度为1:160，呈斑点状模式，且同时存在抗蛋白酶3抗体（pANCA）和抗髓过氧化物酶抗体（cANCA）。该患者被诊断为嗜酸性肉芽肿性多血管炎（EGPA），并开始接受静脉注射类固醇和环磷酰胺治疗。EGPA是一种罕见的多器官血管炎，其特征为哮喘、鼻窦炎和嗜酸性粒细胞增多。在疾病初期通常看不到血管炎累及，因此EGPA是一个诊断难题。
