Intravenous cyclophosphamide and immunoglobulin ameliorated visual field defects in a patient with eosinophilic granulomatosis with polyangiitis
Treating ocular involvement in eosinophilic granulomatosis with polyangiitis (EGPA) can be challenging. We present the case of a 37-year-old woman with EGPA who had severe bilateral visual field defects. Laboratory results showed leukocytosis (17,500 WBC/μL, 25.8 % eosinophils), negative MPO-ANCA ti...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Respiratory Medicine Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007124000030 |
| _version_ | 1797319433737207808 |
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| author | Yuto Motobayashi Chiyako Oshikata Yuka Kodama Kosuke Terada Yuga Yamashita Ryo Nakadegawa Hinako Masumitsu Reeko Osada Hirokazu Takayasu Nami Masumoto Saki Manabe Takeshi Kaneko Akira Shiraishi Naomi Tsurikisawa |
| author_facet | Yuto Motobayashi Chiyako Oshikata Yuka Kodama Kosuke Terada Yuga Yamashita Ryo Nakadegawa Hinako Masumitsu Reeko Osada Hirokazu Takayasu Nami Masumoto Saki Manabe Takeshi Kaneko Akira Shiraishi Naomi Tsurikisawa |
| author_sort | Yuto Motobayashi |
| collection | DOAJ |
| description | Treating ocular involvement in eosinophilic granulomatosis with polyangiitis (EGPA) can be challenging. We present the case of a 37-year-old woman with EGPA who had severe bilateral visual field defects. Laboratory results showed leukocytosis (17,500 WBC/μL, 25.8 % eosinophils), negative MPO-ANCA titer, and elevated PR3-ANCA level (33.2 IU/mL). Diffusion-weighted MRI revealed bilateral hyperintense occipital lesions, which were more prominent on the left. Her therapy initially included a steroid pulse, followed by daily prednisolone, but her visual field defects remained refractory. The addition of intravenous cyclophosphamide (5 courses) and intravenous immunoglobulin decreased her optic neuropathy and resolved her visual field defects. |
| first_indexed | 2024-03-08T04:07:49Z |
| format | Article |
| id | doaj.art-ad5fcb53e8004ffda62f3f4f52cd98cf |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-03-08T04:07:49Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-ad5fcb53e8004ffda62f3f4f52cd98cf2024-02-09T04:48:14ZengElsevierRespiratory Medicine Case Reports2213-00712024-01-0147101980Intravenous cyclophosphamide and immunoglobulin ameliorated visual field defects in a patient with eosinophilic granulomatosis with polyangiitisYuto Motobayashi0Chiyako Oshikata1Yuka Kodama2Kosuke Terada3Yuga Yamashita4Ryo Nakadegawa5Hinako Masumitsu6Reeko Osada7Hirokazu Takayasu8Nami Masumoto9Saki Manabe10Takeshi Kaneko11Akira Shiraishi12Naomi Tsurikisawa13Department of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, Japan; Department of Allergy and Respirology, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa, 254-0065, Japan; Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, Japan; Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, JapanDepartment of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, JapanDepartment of Ophthalmology, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa, 254-0065, JapanDepartment of Respirology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, Japan; Department of Allergy and Respirology, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa, 254-0065, Japan; Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan; Corresponding author. Department of Respirology, National Hospital Organization Yokohama Medical Center 3-60-2 Harajuku, Totsuka-ku, Yokohama, 245-8575, Japan.Treating ocular involvement in eosinophilic granulomatosis with polyangiitis (EGPA) can be challenging. We present the case of a 37-year-old woman with EGPA who had severe bilateral visual field defects. Laboratory results showed leukocytosis (17,500 WBC/μL, 25.8 % eosinophils), negative MPO-ANCA titer, and elevated PR3-ANCA level (33.2 IU/mL). Diffusion-weighted MRI revealed bilateral hyperintense occipital lesions, which were more prominent on the left. Her therapy initially included a steroid pulse, followed by daily prednisolone, but her visual field defects remained refractory. The addition of intravenous cyclophosphamide (5 courses) and intravenous immunoglobulin decreased her optic neuropathy and resolved her visual field defects.http://www.sciencedirect.com/science/article/pii/S2213007124000030ANCA-Associated vasculitisCyclophosphamideEosinophilic granulomatosis with polyangiitisIVIGOptic neuritisVisual field defects |
| spellingShingle | Yuto Motobayashi Chiyako Oshikata Yuka Kodama Kosuke Terada Yuga Yamashita Ryo Nakadegawa Hinako Masumitsu Reeko Osada Hirokazu Takayasu Nami Masumoto Saki Manabe Takeshi Kaneko Akira Shiraishi Naomi Tsurikisawa Intravenous cyclophosphamide and immunoglobulin ameliorated visual field defects in a patient with eosinophilic granulomatosis with polyangiitis Respiratory Medicine Case Reports ANCA-Associated vasculitis Cyclophosphamide Eosinophilic granulomatosis with polyangiitis IVIG Optic neuritis Visual field defects |
| title | Intravenous cyclophosphamide and immunoglobulin ameliorated visual field defects in a patient with eosinophilic granulomatosis with polyangiitis |
| title_full | Intravenous cyclophosphamide and immunoglobulin ameliorated visual field defects in a patient with eosinophilic granulomatosis with polyangiitis |
| title_fullStr | Intravenous cyclophosphamide and immunoglobulin ameliorated visual field defects in a patient with eosinophilic granulomatosis with polyangiitis |
| title_full_unstemmed | Intravenous cyclophosphamide and immunoglobulin ameliorated visual field defects in a patient with eosinophilic granulomatosis with polyangiitis |
| title_short | Intravenous cyclophosphamide and immunoglobulin ameliorated visual field defects in a patient with eosinophilic granulomatosis with polyangiitis |
| title_sort | intravenous cyclophosphamide and immunoglobulin ameliorated visual field defects in a patient with eosinophilic granulomatosis with polyangiitis |
| topic | ANCA-Associated vasculitis Cyclophosphamide Eosinophilic granulomatosis with polyangiitis IVIG Optic neuritis Visual field defects |
| url | http://www.sciencedirect.com/science/article/pii/S2213007124000030 |
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