Eosinophilic granulomatosis with polyangiitis

Case contributed by Dr Yair Glick

Presentation

Worsened cough and shortness of breath. History of eosinophilic granulomatosis with polyangiitis (EGPA) treated with azathioprine and prednisone, and emphysema due to heavy smoking.

Patient Data

Age: 70 years
Gender: Male

Patchy infiltrates with prominent interstitial markings in the upper and lower zones of the right lung and all three zones of the left lung. 
Hiatus hernia.

Bronchial wall thickening and cylindrical bronchiectasis, probably due to longstanding COPD and asthma (the latter is present in virtually all EGPA patients).
Ground glass opacity with thickened intralobular septae in the left lung apex; similar lingular opacity; smaller but similar paramediastinal opacity in the right upper lobe. None were present on a CT chest scan done 6 months prior (not shown).
No axillary, mediastinal or hilar lymphadenopathy.
Moderate-sized hiatal hernia.

Case Discussion

Fleeting pulmonary infiltrates are a classical sign of EGPA (Churg-Strauss syndrome).

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Case information

rID: 70246
Published: 11th Aug 2019
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included
Institution: Laniado Hospital

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