Eosinophilic granulomatous polyangiitis with lung involvement: clinical analysis of 8 cases

Clinical data, imaging finding, laboratory and pathology results of 8 patients with eosinophilic granulomatous polyangiitis (EGPA) admitted in our hospital from April 2014 to September 2016 were retrospectively analyzed. There were 7 cases with sinus involvement; 8 cases with increased eosinophil counts in peripheral blood, bronchoalveolar lavage fluid (BALF) and induced sputum, and with negative antineutrophil cytoplasmic antibodies (ANCA). Lung function tests showed mild obstructive ventilation dysfunction in 7 cases, positive relaxation test or excitation test in 4 cases, and mild dispersion function decline in 4 cases. Chest CT revealed multiple ground glass shadows and peripheral pulmonary nodules in both lungs in 4 cases, and bronchial wall thickening in 1 case. Transbrochial lung biopsy (TBLB) indicated extravascular infiltration of acidophilic granulocytes. Four cases were treated by glucocorticoid monotherapy, the other 4 cases were treated by glucocorticoids combined with cyclophosphamide. All patients achieved clinical relief after treatment, but 3 cases recurred. For suspicious EGPA patients in addition to paranasal sinus CT, ANCA vasculitis index, urine routine and renal function tests, it is necessary to perform nasal mucosa, bronchial mucosa, transbrochial lung biopsy and BLAF, induced sputum cytology to obtain timely diagnosis and treatment. Key words: Churg-Strauss syndrome; Bronchial alveolar lavage fluid