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

Liu, Yanming; Chen, Zhengli; Zhu, Shumin; Bai, Fan; Liu, Yuecai; Gao, Lingling; Li, Xinyuan; Geng, Yulan; Zhang, Guoqiang

doi:10.21037/apm-21-2236

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…The patient usually has a history of chronic asthma, longstanding rhinitis, recurrent sinusitis, otitis media, nasal obstruction, and nasal polyposis. Asthma is one of the most common associations of EGPA and has several types which include allergic asthma mediated by IgE, aspirin-exacerbated respiratory disease, exercise-induced asthma, non-allergic asthma often triggered by viral upper respiratory tract infections or no apparent cause, and cough variant asthma [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our patient was ANCA negative with high levels of eosinophils in the bone marrow and peripheral blood with respiratory, cutaneous, neural, and skeletal manifestations. The possible mechanism of organ injury is eosinophil-associated vascular occlusion leading to ischemia and eosinophil-associated tissue damage [ 12 ]. In the vasculitic phase of the disease, histopathology shows eosinophilic infiltration of the vessel walls and necrotizing eosinophilic granuloma in extravascular tissue [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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ANCA-Negative EGPA With Pulmonary, Cutaneous, and Neurological Manifestations in a 25-Year-Old Male: A Case Report

Shehryar¹,

Sajid²,

Haseeb³

et al. 2022

Cureus

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Eosinophilic granulomatosis with polyangiitis is a systemic vasculitis characterized by the presence of asthma, hyper-eosinophilia, and necrotizing vasculitis with extravascular eosinophilic granulomas. We report the case of a 25-year-old male who presented to the outpatient department complaining of joint aches and numbness in the hands and legs. Physical examination revealed erythematous blanchable macular rashes on palms and soles. Raynaud's phenomenon was also observed. Lab workup revealed elevated WBC count and peripheral blood eosinophilia. Antibody tests were positive only for anti-nuclear antibodies. A diagnosis of eosinophilic granulomatosis with polyangiitis including peripheral neuropathy, arthralgia, rash, and pulmonary manifestations was established. The patient was started on a therapeutic regimen of corticosteroids and immunosuppressants, which halted the progression of the disease. Peripheral neuropathy and arthralgia also improved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

ANCA-Negative EGPA With Pulmonary, Cutaneous, and Neurological Manifestations in a 25-Year-Old Male: A Case Report

Shehryar¹,

Sajid²,

Haseeb³

et al. 2022

Cureus

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“…CRP has been reported to be elevated in both antineutrophil cytoplasmic antibody-negative and -positive eosinophilic granulomatosis with polyangiitis. Also, hsCRP was found to be higher in Wegener’s granulomatosis cases that are in relapse, and serial CRP measurement fills the urgent need for an objective index of the activity of this disease [ 668 , 669 , 670 , 671 ]. Apart from Kawasaki disease, in which data are contrasted, some authors believe that arteriosclerosis is an autoimmune condition; hsCRP has been correlated with disease severity, and a study found that SNPs affect arterial pulse wave velocity in healthy people [ 672 , 673 ].…”

Section: Current Evidence On C-reactive Protein and Potential Conditionsmentioning

confidence: 99%

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians

Mouliou

2023

Diseases

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The current literature provides a body of evidence on C-Reactive Protein (CRP) and its potential role in inflammation. However, most pieces of evidence are sparse and controversial. This critical state-of-the-art monography provides all the crucial data on the potential biochemical properties of the protein, along with further evidence on its potential pathobiology, both for its pentameric and monomeric forms, including information for its ligands as well as the possible function of autoantibodies against the protein. Furthermore, the current evidence on its potential utility as a biomarker of various diseases is presented, of all cardiovascular, respiratory, hepatobiliary, gastrointestinal, pancreatic, renal, gynecological, andrological, dental, oral, otorhinolaryngological, ophthalmological, dermatological, musculoskeletal, neurological, mental, splenic, thyroid conditions, as well as infections, autoimmune-supposed conditions and neoplasms, including other possible factors that have been linked with elevated concentrations of that protein. Moreover, data on molecular diagnostics on CRP are discussed, and possible etiologies of false test results are highlighted. Additionally, this review evaluates all current pieces of evidence on CRP and systemic inflammation, and highlights future goals. Finally, a novel diagnostic algorithm to carefully assess the CRP level for a precise diagnosis of a medical condition is illustrated.

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Detection of serum interleukin-18 level and neutrophil/lymphocyte ratio in patients with antineutrophil cytoplasmic antibody-associated vasculitis and its clinical significance

Liu

2024

Open Life Sciences

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Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune diseases. This study aimed to investigate the clinical significance of changes in interleukin-18 (IL-18) and neutrophil/lymphocyte ratio (NLR) in the pathogenesis of AAV and the impact of NLR on the prognosis of patients. The clinical data of 52 AAV patients (AAV group) who met the conditions of hospitalization, 30 patients with mild mesangial proliferative glomerulonephritis (disease controls), and 30 healthy volunteers (normal controls) in Nephrology Department of Liuzhou People’s Hospital from May 2020 to August 2022 were selected. A total of 52 AAV patients were divided into active phase (>15 points) and remission phase (≤15 points) based on the Birmingham vasculitis activity score (BVAS). Serum IL-18 level was detected by enzyme-linked immunosorbent assay in three groups. Pearson product moment correlation analysis was performed to investigate the correlation between serum IL-18 levels and clinical laboratory indicators, and receiver operating characteristic (ROC) curve analysis was performed on serum IL-18, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) levels, and NLR in AAV patients. The levels of serum creatinine, parathyroid hormone, β2-microglobulin (β2-MG), ESR, CRP, and IL-18 in active stage of AAV were significantly higher than those in remission stage of AAV. Moreover, the serum IL-18 level of active AAV patients was significantly higher than that of disease control group (P < 0.05). The levels of eGFR, hemoglobin, and complement C3 were significantly lower than those during the remission (P < 0.05). Pearson product moment correlation analysis showed that serum IL-18 level in AAV patients was positively correlated with BVAS score and ESR level. The area under the curve of serum IL-18, NLR, CRP, ESR levels evaluated by ROC curve was 0.921, 0.899, 0.83, and 0.75, respectively. Kaplan–Meier survival curve showed that the cumulative survival rate of patients in low NLR group was significantly higher than that in high NLR group (68.36 vs 42.89%), with significant difference (Log-Rank = 6.745, P = 0.025 < 0.05). IL-18 may be adopted as one of the important biological markers to judge the disease of AAV, and the cumulative survival rate of patients with high NLR is low, which may be applied as an indicator to evaluate the poor prognosis of patients with AAV.

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

Cited by 3 publications

References 35 publications

ANCA-Negative EGPA With Pulmonary, Cutaneous, and Neurological Manifestations in a 25-Year-Old Male: A Case Report

ANCA-Negative EGPA With Pulmonary, Cutaneous, and Neurological Manifestations in a 25-Year-Old Male: A Case Report

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians

Detection of serum interleukin-18 level and neutrophil/lymphocyte ratio in patients with antineutrophil cytoplasmic antibody-associated vasculitis and its clinical significance

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