Abstract
A 60-year-old man presented with a 3-month history of intermittent low-grade fever, abdominal pain, diarrhea, facial swelling, and purpura of the lower extremities. He had a 20-year history of bronchial asthma. On physical examination, facial swelling and edema were noted (Figure A). Purpura of bilateral foot drops were also present (Figure B). There was no tenderness on palpation in the abdomen. Increased bowel sounds were noted. Laboratory values were as follows: white blood cell count, 5300/mm3 with 35% eosinophils; C-reactive protein, 12.2 mg/dL (normal <0.27 mg/dL); and IgE, 1100 U/mL (normal <500 IU/mL). Antinuclear antibodies, antineutrophil cytoplasmic antibodies, and stool culture were negative. A colonoscopic image (Figure C) is depicted. During his hospital course, he developed mononeuritis multiplex, causing paresthesias in lower extremities. What is the diagnosis?
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