Colitis as the Initial Presentation of Eosinophilic Granulomatosis with Polyangiitis

Author:

Menon Sharika Gopakumar1ORCID,Hugenberg Steven1ORCID,Alkashash Ahmad M.2ORCID,Lin Jingmei2ORCID,Iranmanesh Arya M.3

Affiliation:

1. Department of Medicine, Rheumatology Division, Indiana University School of Medicine, Indianapolis, Indiana, USA

2. Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA

3. Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana, USA

Abstract

A male patient in his early sixties with recurrent diarrhea was transferred to our hospital. The patient did not have any pulmonary or upper respiratory symptoms. He was noted to have peripheral eosinophilia. Further workup revealed a negative antineutrophilic cytoplasmic antibody titer but a positive myeloperoxidase antibody and positive proteinase 3 antibodies. A colon biopsy also revealed eosinophilic-rich granulomas in the mucosa, confirming a diagnosis of eosinophilic granulomatosis with polyangiitis. On cardiac imaging, eosinophilic myocarditis was also discovered. To treat active severe EGPA, the patient received high-dose corticosteroids and intravenous cyclophosphamide. The occurrence of gastrointestinal involvement as an initial manifestation of eosinophilic granulomatosis with polyangiitis is infrequent, emphasizing the significance of its recognition. This case underscores the importance of identifying and diagnosing such atypical presentations to facilitate timely and appropriate management.

Publisher

Hindawi Limited

Subject

General Agricultural and Biological Sciences

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