The analysis of clinical characteristics on eosinophilic granulomatosis with polyangiitis: a report of 23 cases

Abstract

Objective To analyze the clinical features of eosinophilic granulomatosis with polyangiitis (EGPA). Methods The clinical characteristics, laboratory test, therapeutic regimen, pathology and imaging diagnosis in 23 cases with EGPA from the First Affiliated Changhai Hospital of Second Military Medical University within June 2007 to January 2013 were retrospectively analyzed. Results There were 14 males and 9 females, with the age ranged from 21 to 68 years. The mean age was (42±9) years. The overall prevalence of asthma was 78% (18/23). The allergic rhinitis accounted for 61% (14/23). The maxillary sinuses were the most frequently involved, which accounted for 57%(13/23). Skin involvement was 57%(13/23), peripheral neuritis was 70% (16/23). Central nervous system involvement presented cerebrovascular event. Cardiac involvement accounted for 48% (11/23), digestive system involvement accounted for 17% (4/23). The outcome of auxiliary laboratory test revealed that 96% (22/23) patients expressed significantly higher levels of IgE and 70% (16/23) patients carried anti-neutrophil cytoplasmic antibodies (ANCA) which were presented as the perinuclear ANCA (p-ANCA). The patchy infiltrates of lung CT scan accounted for 69% (11/23). EMG showed mononeuritis multiplex and symmetric sensory motor neuropathy. The abnormal ratios of ECG and Echocardiography were 48% (11/23), 79%(11/14) respectively. The pathological manifestations were necrotizing vasculitis, eosinophilic tissue infiltration, and extravascular granulomas. Conclusion Our results confirm the heterogenicity in clinical presentation and lack of specificity. Early diagnosis and treatment will be helpful for good prognosis. Key words: Churg-Strauss syndrome; Pathological conditions, signs and symptoms