A Rare Case of Eosinophilic Granulomatosis with Polyangiitis Following Development of Central Diabetes Insipidus: A Case Report and Literature Review

Tatsuaki Kosaka; Shinya Yamamoto; Naoko Yasugi; Sayaka Sugioka; Takuro Hakata; Rintaro Saito; Ryosuke Hiwa; Sho Koyasu; Yuki Teramoto; Motoko Yanagita

doi:10.2169/internalmedicine.5558-25

Tatsuaki Kosaka, Shinya Yamamoto, Naoko Yasugi, Sayaka Sugioka, Takuro Hakata, Rintaro Saito, Ryosuke Hiwa, Sho Koyasu, Yuki Teramoto, Motoko Yanagita

Author information

Tatsuaki Kosaka
Department of Nephrology, Graduate School of Medicine, Kyoto University, Japan
Shinya Yamamoto
Department of Nephrology, Graduate School of Medicine, Kyoto University, Japan
Naoko Yasugi
Department of Nephrology, Graduate School of Medicine, Kyoto University, Japan
Sayaka Sugioka
Department of Nephrology, Graduate School of Medicine, Kyoto University, Japan
Takuro Hakata
Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Japan
Rintaro Saito
Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Japan
Ryosuke Hiwa
Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Japan
Sho Koyasu
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Japan
Yuki Teramoto
Department of Diagnostic Pathology, Kyoto University Hospital, Japan
Motoko Yanagita
Department of Nephrology, Graduate School of Medicine, Kyoto University, Japan
Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Japan

Keywords: eosinophilic granulomatosis with polyangiitis, EGPA, central diabetes insipidus, CDI, acute kidney injury, dialysis

JOURNAL OPEN ACCESS Advance online publication

Article ID: 5558-25

DOI https://doi.org/10.2169/internalmedicine.5558-25

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Abstract

Central diabetes insipidus (CDI) can develop as an acquired systemic disease. However, cases of eosinophilic granulomatosis with polyangiitis (EGPA) with concurrent CDI are rare. We herein report a case of EGPA following CDI. A 68-year-old woman with a 30-year history of sinusitis and asthma developed CDI, followed by severe renal dysfunction with eosinophilia and elevated MPO-ANCA levels. A renal biopsy confirmed EGPA. Intensive treatment resulted in dialysis discontinuation, while partial improvement in AVP secretion suggested a potential link between EGPA and CDI. We also conducted a literature review on concurrent EGPA and CDI. Clinicians should be aware of EGPA in CDI patients with asthma or sinusitis.

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