Eosinophilic granulomatosis with polyangiitis: easy to miss at an early stage; easy to halt progression if caught early; a success story presented as a case report

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multisystemic small-vessel vasculitic disease. We report a case of non-severe eosinophilic granulomatosis with polyangiitis who was treated early in its course and remained in remission. A 57-year-old lady presented with new-onset episodic wheezing for six months. This was associated with rhinitis, sinusitis and chronic urticaria for the same duration. Examination revealed tender skin nodules.  Investigations revealed elevated inflammatory markers with positive Myeloperoxidase (MPO) antibodies. She was diagnosed with the early stage of eosinophilic granulomatosis with polyangiitis. She was treated with oral prednisolone and mycophenolate mofetil as induction therapy and treatment is maintained with mycophenolate mofetil. She remains in remission to date. This case highlights the importance of early detection and treatment of Antineutrophil cytoplasmic antibodies (ANCA)-associated-vasculitis and explores the potential of mycophenolate mofetil as a therapeutic agent.