Stellate ganglion block as an intervention in refractory eosinophilic granulomatosis with polyangiitis: a case report

Abstract

Background Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare vasculitis. Although glucocorticoid therapy with or without immunosuppressants leads to remission in the majority of cases, most EGPA patients remain dependent on glucocorticoid therapy and experience frequent relapses. Here, we report a case of refractory EGPA which responded to stellate ganglion blocks (SGBs). Case presentation A 32-year-old woman with aggravated wheezing, purpura, numbness of multiple fingers, and epigastric and abdominal pain was referred to our clinic. Laboratory and radiographic studies led to the diagnosis of EGPA. After an initial favorable response to glucocorticoid and immunosuppressant therapy, she experienced a relapse during a glucocorticoid taper. We found that SGB brought symptomatic relief and impeded disease progression. The mechanism of action of SGB on EGPA is undetermined, but may be related to vasodilation, immune modulation, and central nervous system regulation. Conclusions This report not only proposes a novel treatment modality for EGPA, but also provides a clinical reference point for further in-depth studies of SGB in multiple immune-linked disorders.

Ganglionic Plexus Ablation: A Step-by-step Guide for Electrophysiologists and Review of Modalities for Neuromodulation for the Management of Atrial Fibrillation

“…GP = ganglionated plexus. Source: Image for stellate ganglion blockage: Ma D et al [ 122 ] Reproduced from Springer Nature under a Creative Commons CC BY licence.…”