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Spontaneous Mesenteric Hemorrhage Associated With Eosinophilic Granulomatosis With Polyangiitis : A Case Report

By: Matthew Chan, Ambreen Khan, & Keltie Anderson

Eosinophilic granulomatosis with polyangiitis is a systemic inflammatory disorder affecting small and medium sized arteries, characterized by asthma, eosinophilia, and systemic vasculitis. Patients diagnosed with EGPA can present acutely unwell due to significant cardiac and gastrointestinal involvement, often requiring intensive care admission. We present an unusual case of EGPA in a 49-year-old patient who was admitted to the ICU due to a spontaneous mesenteric arterial bleed. She had no history of asthma, however, did present with other features of EGPA including neuropathy, paranasal sinus abnormalities, marked eosinophilia, and biopsy-proven active vasculitis. The patient had a surgical ligation of the bleeding vessel, and subsequently her disease was induced into remission with cyclophosphamide and high dose steroid therapy. This case report and literature review analyzes a rare and life-threatening complication of EGPA and its associated management.
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