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Eosinophilic Granulomatosis with Polyangiitis Diagnosed Based on Digestive Tract Lesions, Report of a Case Yoshiaki Nozaka 1 , Koichi Kurahara 1 , Yumi Oshiro 2 , Mitsuyoshi Minami 3 , Yasuharu Okamoto 1,4 , Takahide Tanaka 1,4 , Shinjiro Egashira 1,4 , Koji Ikegami 1 , Takehiro Torisu 4 1Division of Gastroenterology, Matsuyama Red-cross Hospital, Matsuyama, Japan 2Department of Pathology, Matsuyama Red-cross Hospital, Matsuyama, Japan 3Department of Dermatology, Matsuyama Red-cross Hospital, Matsuyama, Japan 4Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Keyword: 好酸球性多発血管炎性肉芽腫症 , ANCA関連血管炎 , 消化管病変 , 小腸病変 , 大腸病変 pp.1001-1007
Published Date 2024/7/25
DOI https://doi.org/10.11477/mf.1403203674
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 The patient was a man in his 60s. In 20XX-2 he developed bronchial asthma. In 20XX-1, he was diagnosed with eosinophilic pneumonia at the Respiratory Medicine Department of our hospital and received oral steroid treatment. In 20XX, the patient presented to our department with epigastric pain and bloody stools. A large intestine endoscopy revealed multiple geographical ulcers with redness surrounding the distal sigmoid colon and the rectum. A small intestine capsule endoscopy revealed scattered ulcerative lesions similar to colonic lesions in the upper and lower small intestine. A search for a skin lesions revealed multiple retiform purpura on the trunk and extremities, and a skin biopsy revealed necrotizing vasculitis in the tissue taken from the retiform purpura on the buttocks, leading to the definitive diagnosis of EGPA(eosinophilic granulomatosis with polyangiitis). The patient was treated with high-dose intravenous cyclophosphamide because of cardiac lesions and neuritis. In this case, we looked for skin lesions because EGPA was suspected based on the endoscopic findings of characteristic small intestinal and colorectal lesions, and skin biopsy of the purpura led to the definitive diagnosis of EGPA.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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