Eosinophilic Granulomatosis with Polyangiitis Initially Diagnosed as Eosinophilic Gastroenteritis

Abstract

We herein report two cases of eosinophilic granulomatosis with polyangiitis (EGPA) initially diagnosed as eosinophilic gastroenteritis (EGE) based solely on endoscopic biopsy results. One year after the EGE diagnosis, one patient presented with multiple purpura, and skin biopsy findings resulted in a change of the diagnosis to EGPA. In another patient, multiple skin and colonic ulcerations emerged eight years after the diagnosis of EGE, at which time histological examinations of endoscopic biopsy specimens revealed vasculitis, and the diagnosis was changed to EGPA. Physicians should be aware of the possible existence of EGPA in cases diagnosed as EGE.

Negative anti-neutrophil cytoplasmic antibodies and eosinophilic granulomatosis with polyangiitis accompanied by cough variant asthma: a case report

“…Patients have typical age demographics for this disease, with few cases occurring during childhood and in those over 70 years (7). We also noticed that female adults are more likely to get EGPA based on case reports published in recent years (8)(9)(10)(11)(12)(13)(14), while about 38% of children with EGPA are female (15). Some studies suggest that cutaneous manifestations are present in 40% to 81% of EGPA patients (16).…”

Eosinophilic Gastroenteritis in the Small Intestine Mimicking Eosinophilic Granulomatosis With Polyangiitis in a Young Male Patient

“…Endoscopic findings can differ in the initial phases of EGE and EGPA. However, the involvement of chronic relapsing inflammation may change the endoscopic findings of EGE, resembling EGPA and vasculitis, as seen in our case [3,4]. Endoscopically diagnosing EGE and ruling out EGPA can be challenging.…”

“…Therefore, physicians should take precise clinical histories and conduct proper physical examinations to differentiate between these diseases. Moreover, the progression of EGE could cause vasculitis such as EGPA; therefore, physicians should follow their symptoms and further investigate the exacerbation to search for vasculitis [4].…”

“…EGE may cause acute and chronic inflammation localized in the small intestine, similar to vasculitis in endoscopic findings. This type of disease is rare and has not been frequently described in the clinical course [4,5]. We encountered a young male patient with EGE who progressed rapidly during the clinical course.…”

Discrepancy between Abdominal Symptoms and Endoscopic Findings in Patients with Gastro-duodenal Eosinophilia: A Case Series

“…This case series showed that there was a discrepancy between symptoms and endoscopic findings in some cases, indicating that EGE-like endoscopic findings and allergic mechanisms may be involved, even in patients with asymptomatic gastroduodenal eosinophilic infiltration. Itawaki et al reported two cases of eosinophilic granulomatosis with polyangiitis (EGPA) that were initially diagnosed as EGE ( 7 ). Similarly, there were two cases of EGPA and one case of subcutaneous angioblastic lymphoid hyperplasia with eosinophilia in our report.…”