Anti-proteinase 3-positive Eosinophilic Granulomatosis with Polyangiitis Revealed by Cardiac Tamponade

Intern Med. 2019 Oct 15;58(20):3045-3050. doi: 10.2169/internalmedicine.2937-19. Epub 2019 Jun 27.

Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis characterized by asthma, eosinophilia, and diffuse eosinophilic infiltration. Although cardiovascular involvement is common and a leading cause of EGPA-related mortality, severe pericarditis-led cardiac tamponade occurs rarely. We herein report a 72-year-old man with anti-proteinase 3 (anti-PR3) anti-neutrophil cytoplasmic antibody (ANCA)-positive EGPA diagnosed by the presence of cardiac tamponade, which responded quickly to pericardiocentesis and a single administration of prednisolone. This is the first case of anti-PR3 ANCA-positive EGPA with cardiac tamponade; the patient displayed clinical features of both ANCA-positive and ANCA-negative cases.

Keywords: Churg-Strauss syndrome; anti-proteinase 3 anti-neutrophil cytoplasmic antibodies; cardiac tamponade; eosinophilic granulomatosis with polyangiitis; pericarditis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Antineutrophil Cytoplasmic / immunology
  • Cardiac Tamponade / diagnosis
  • Cardiac Tamponade / etiology*
  • Diagnosis, Differential
  • Echocardiography
  • Eosinophilia / complications*
  • Eosinophilia / diagnosis
  • Eosinophilia / metabolism
  • Granulomatosis with Polyangiitis / complications*
  • Granulomatosis with Polyangiitis / diagnosis
  • Granulomatosis with Polyangiitis / metabolism
  • Humans
  • Male
  • Myeloblastin / immunology*
  • Myeloblastin / metabolism
  • Tomography, X-Ray Computed

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Myeloblastin