Eosinophilic Granulomatosis With Polyangiities:Two Cases Report And Literature Review

Objective To enhance the understanding of eosinophilic granulomatosis with polyangiities(EGPA) by summarizing its clinical features and improve disease prognosis through early diagnosis. Methods The clinical manifestations, laboratory findings, imaging and pathology diagnosis in 2 cases with EGPA from the First Affiliated Hospital of Chongqing Medical University and 135 cases with EGPA reported online within January 2011 to December 2015 were retrospectively investigated.Results There were 80 males and 57 females, sex ratio was 1:0.71. The most common clinical manifestations of EGPA featured involvement of respiratory system(91.2%), including lung infiltration, asthma and nasosinusitis. The other involved systems were nervous system(64.2%),skin(39.4%), urinary system(36.5%), cardiovascular system(32.8%),joint-muscle system(32.1%), digestive system(20.4%). The rate of eosinophil percentage >10% was in 117 patients(96.6%). In 112 cases with anti-neutrophil cytoplasmic antibodies(ANCA) test, the positive rates of perinuelear ANCA(p-ANCA) and cytoplasmic ANCA(c-ANCA) were53.6% and 6.0%, respectively. The main presentations of lung image were ground-glass infiltration and nodule. The involvement of nasosinusitis of EGPA was multi-group and the maxillary sinuses were the most frequently involved. The positive rate of pathology was 86%(86/100), biopsy tissue collected from skin(22), lung(20), muscle(20), kidney(16), stomach orcolon(9), lymph nodes(6), nasal mucosa(5), nerve(1), brain(1), the positive rate of pathology was 86%(86/100). The pathological manifestations were necrotizing eosinophilic tissue infiltration, vasculitis and extravascular granulomas.Conclusion EGPA is a rare disease. Due to the lack of pathognomonic symptoms, EGPA could be easily misdiagnosed.Better understanding of EGPA, early diagnosis and treatment will be helpful for good prognosis.