A Man with Shortness of Breath, Weight Loss, and Eosinophilia

He had been unwell for 8 months. Additional symptoms at different times included sinus congestion, rhinorrhea, and wheezing. He had received treatment for influenza A and pneumonia within the previous 8 months, but opacities persisted on chest radiography. On the day of admission, his oxygen saturation was 70% breathing ambient air, and his absolute eosinophil count was 27,390 cells per microliter. Positive immunofluorescence staining for antineutrophil cytoplasmic antibody (with a cytoplasmic pattern; c-ANCA) along with a proteinase 3 titer of >100 U/ml established the diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA).

Comment

I really liked the clinician’s diagnostic schema for eosinophilia (see Figure 1); I was not familiar…

Clement D. Lee, M.D., M.Sc.Commentary Author

Disclosures

Nothing to disclose

Clement D. Lee, M.D., M.Sc.Commentary Author

Disclosures

Nothing to disclose