A case of eosinophilic granulomatosis with polyangiitis preceded by allergic bullous lesions.

IF 0.9 Q4 RHEUMATOLOGY

Modern rheumatology case reports Pub Date : 2024-09-11 DOI:10.1093/mrcr/rxae046

Eiko Hasegawa, Momoko Iijima, Akinari Sekine, Noriko Inoue, Kiho Tanaka, Tatsuya Suwabe, Masayuki Yamanouchi, Yuki Oba, Ayako Kume, Kei Kono, Keiichi Kinowaki, Kenichi Ohashi, Yutaka Yamaguchi, Yasuhiro Suyama, Takehiko Wada, Naoki Sawa, Kotono Takahashi, Shigeharu Ueki, Yoshifumi Ubara

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Abstract

A 62-year-old man with a history of diabetes mellitus was hospitalised with numbness of lower limbs, bullous lesions of the whole body, kidney dysfunction, presence of eosinophils, and elevated antineutrophil cytoplasmic antibodies to myeloperoxidase and anti-bullous pemphigoid 180 antibodies and was diagnosed with mononeuritis multiplex. Kidney and muscle biopsies showed vasculitis with fibrinoid necrosis, whereas skin biopsies showed only blister formation between the epidermis and dermis; a high eosinophilic infiltrate was present in all three tissues. These findings led to a diagnosis of eosinophilic granulomatosis with polyangiitis combined with allergic bullous lesions. Immunohistological examination indicated cytolytic eosinophils and extracellular traps, suggesting the presence of eosinophil extracellular trap cell death (eosinophil ETosis) in diseased tissue.

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一例嗜酸性粒细胞肉芽肿伴多血管炎病例，发病前出现过敏性大疱。

一名有糖尿病史的 62 岁男子因下肢麻木、全身牛皮样病变、肾功能障碍、嗜酸性粒细胞存在、抗中性粒细胞胞浆抗体髓过氧化物酶抗体和抗牛皮样丘疹 180 抗体升高而住院，被诊断为单核细胞增多性肾炎。肾脏和肌肉活检显示血管炎伴有纤维素性坏死，而皮肤活检仅显示表皮和真皮之间有水疱形成；这三种组织中均有大量嗜酸性粒细胞浸润。这些结果导致了嗜酸性粒细胞肉芽肿伴多血管炎合并过敏性大疱病变的诊断。免疫组织学检查显示，嗜酸性粒细胞和细胞外陷阱细胞溶解，提示病变组织中存在嗜酸性粒细胞细胞外陷阱细胞死亡（嗜酸性粒细胞ETosis）。

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来源期刊

Modern rheumatology case reports

CiteScore

1.40

自引率

0.00%

发文量