Eosinophilic granulomatosis with polyangiitis (EGPA) is a disease with marked elevation of blood eosinophil associated with various symptoms in the respiratory tract, gastrointestinal tract, peripheral nerves, and skin due to systemic vasculitis. Here, we report a case of EGPA in which rhinosinusitis was treated with endoscopic sinus surgery (ESS) with good results. A 49-year-old man who developed bronchial asthma at age 48 was diagnosed with EGPA in our hospital. Treatment with prednisolone (PSL) and mepolizumab relieved peripheral blood eosinophilia and symptoms caused by systemic vasculitis. However, rhinosinusitis with nasal polyps and olfactory disorder worsened one year after the start of treatment. Topical administration of betamethasone did not improve rhinosinusitis and olfactory disorder, so ESS was performed. At the one-year follow-up, no recurrence of rhinosinusitis and olfactory disorder was observed. ESS may be an effective treatment for rhinosinusitis associated with EGPA.
Keywords: chronic rhinosinusitis; endoscopic sinus surgery; eosinophilic granulomatosis with polyangiitis; mepolizumab; olfactory disorder.