Eosinophilic granulomatous polyangiitis with allergic bronchopulmonary aspergillosis as a comorbidity: a case report and literature review
10.3760/cma.j.cn141217-20201222-00491
- VernacularTitle:以变应性支气管肺曲霉菌病为共病求诊的嗜酸性肉芽肿性多血管炎一例及文献复习
- Author:
Yanfang CHU
1
;
Yazhuo LI
;
Penghui XU
;
Xiangyan KONG
;
Bin YE
;
Minhui LU
;
Huiqiong ZHOU
Author Information
1. 中国人民解放军总医院第四医学中心风湿免疫科，北京 100048
- Keywords:
Aspergillosis, allergic bronchopulmonary;
Vasculitis;
Oxyphil cells;
Asthma
- From:
Chinese Journal of Rheumatology
2021;25(12):811-815,c1
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics, diagnosis and treatment of allergic bronchopulmonary aspergillosis(ABPA) with eosinophilic granulomatous with polyvasculitis(EGPA) as a comorbidity.Methods:We collected the clinical data of a patient with EGPA who sought treatment with ABPA as a comorbidity. We summarized the diagnosis and treatment process of the patient, and reviewed the literature. After that, we discussed the relationship between the pathogenesis of ABPA and EGPA and the diagnosis and treatment experience.Results:A 61-year-old male patient suffered from repeated coughing, expectoration, hemoptysis, wheezing. His blood eosinophils count and immunoglobulin (Ig)E level were elevated. He was tested positive for aspergillus fumigatus. His Computer Tomography (CT) showed pulmonary nodules and bronchiectasis. He was diagnosed as ABPA. He also suffered limb numbness, sinusitis, and renal dysfunction and was diagnosed as EGPA. His condition improved after treatment with glucocorticoids, immunosuppressants and antifungal agents. We reviewed the relevant literature and retrieved 10 case reports, of which 5 cases were diagnosed as ABPA first and then EGPA, 3 cases were diagnosed as EGPA first and then ABPA, 2 cases were diagnosed simultaneously. We found that there was a certain correlation between them in the pathogenesis, and the main treatment is glucocorticoids, immunosuppressants and antifungal drugs.Conclusion:ABPA with EGPA as a comorbidity is rarely reported, which reminds us that when diagnosing one of the diseases in clinical work, we should be alert to the coexistence of another disease to avoid misdiagnosis.
