Case history
Case history
A 34-year-old woman with a 2-year history of poorly controlled asthma and allergic rhinitis presents with new right lower extremity weakness. Electromyogram indicates mononeuritis multiplex.
Other presentations
All patients with EGPA have peripheral eosinophilia and almost all have asthma. The asthma is typically of adult onset and precedes the development of vasculitis by several years. Patients may develop asthma after vasculitis in 10% of cases. The other clinical manifestations can be divided into three groups: those secondary to eosinophilic infiltration, such as eosinophilic pneumonia; those secondary to granulomatous inflammation, such as pulmonary nodules; and those manifestations secondary to vasculitis, such as mononeuritis multiplex. Any organ may be involved, but there is a predilection for ear, nose, and throat involvement (75%), and neurologic involvement (75%). Cardiac involvement is less common but is a major cause of morbidity and mortality. Antineutrophil cytoplasmic antibodies may be present in up to 75% of patients with active vasculitic manifestations but may be as low as 10% in those whose disease is quiescent.[4][5]
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