Asthma or eosinophilic granulomatosis with polyangiitis: a case-based review

Abstract

AbstractBackground:Eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel necrotizing vasculitis. Its most common clinical manifestations are asthma; ear, nose, and throat involvement; and lung involvement. As EGPA has similar features to asthma, most patients with this disease seek medical treatment for the first time with wheezing symptoms and, thus, may be regarded as having asthma.Case presentation:This report discusses an EGPA case regarded as recurrent asthma for 3 years. The patient underwent thoracic computed tomography (CT) 6 times in recent years, which recorded dynamic changes in an EGPA patient’s lungs for the first time. We initiated treatment with methylprednisolone and amethopterin. The patient’s symptoms rapidly improved, and some abnormal imaging manifestations on chest CT disappeared one month after the treatment.Conclusions:Consequently, early diagnosis and treatment are needed because the progression of the disease may be prohibited, and imaging manifestations on chest CT of EGPA may be reversible. Furthermore, to diagnose patients with asthma more reliably and precisely, we discuss the differential diagnosis between EGPA and asthma. Thirdly, imaging manifestations on chest CT could be regarded as an evaluation index to evaluate the therapeutic effect in patients with EGPA. Finally, low-dose CS can alleviate the symptoms of EGPA.