Case of Eosinophilic Polyangiitis Granulomatosa Complicated by Perforation of Small Intestine

Abstract

A 56-year-old woman presented with fever and upper abdominal pain as the main complaints. She was diagnosed with eosinophilic gastroenteritis due to the elevated eosinophil levels in her blood according to the test results. She was admitted to the hospital for closer examination. Various tests were conducted ; however, no evidence of vasculitis was found. The patient was diagnosed with hypereosinophilic syndrome and scheduled for treatment. The patient experienced symptoms of peritonitis and worsening inflammatory findings. After several additional examinations, the patient was diagnosed with gastrointestinal perforation, and emergency surgery was performed. The intraoperative findings revealed small intestinal perforations located 50 and 80 cm from the end of the ileum. The pathological findings revealed eosinophilic infiltration into the submucosa as well as vasculitis in the small intestinal mucosa. Postoperative steroid pulse and immunosuppressive therapies were administered. We describe a case of eosinophilic polyangiitis granulomatosa leading to multiple perforations of the gastrointestinal tract ; we also provide a literature review.