Churg-Strauss syndrome: clinical presentation of eosinophilic vasculitis in a critically ill patient. A case report

• Autores: Vélez-Páez, Jorge Luis, Tirapé Castro, Hugo Arturo, Castro-Bustamante, Christian, Gallegos-Paredes, Manuel Humberto, Molina-Quimbita, Jefferson Xavier
• Formato: artículo
• Fecha de Publicación: 2025
• Institución: Universidad de San Martín de Porres
• Repositorio: Horizonte médico
• Lenguaje: español
• OAI Identifier: oai:horizontemedico.usmp.edu.pe:article/3298
• Enlace del recurso: https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3298
• Nivel de acceso: acceso abierto
• Materia: Granulomatosis Eosinofílica con Poliangeítis; Vasculitis Sistémica; Eosinofilia; Enfermedades de la Piel; Fallo Multiorgánico; Eosinophilic Granulomatosis with Polyangiitis; Systemic Vasculitis; Eosinophilia; Skin Diseases; Multiple Organ Failure

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome,is a rare systemic vasculitis affecting small- and medium-sized vessels. It is characterized by late-onset asthma, peripheral eosinophilia and multiorgan involvement, which may include respiratory, cutaneous, renal, neurological and hematological manifestations. Diagnosis is challenging due to clinical variability and overlapping manifestations with other inflammatory diseases.We present the case of a 58-year-old woman with a history of hypertension and Class III obesity,who was admitted to the emergency department with severe respiratory failure and a six-monthhistory of asthma. During her hospitalization, she developed marked hypereosinophilia, painlesscutaneous lesions compatible with vasculitis, acute renal impairment and thrombocytopeniaassociated with a positive Coombs test. Despite negative c-ANCA and p-ANCA results, the diagnosisof EGPA was made based on clinical findings and subsequently confirmed by histopathologicalexamination, which revealed eosinophil-rich inflammatory infiltrates. Treatment was providedwith corticosteroid pulses and immunosuppression with rituximab, achieving complete resolutionof the multisystemic manifestations and hospital discharge in stable condition. This case underscores the importance of prompt diagnosis in rare diseases such as EGPA, where clinical suspicion and early therapeutic intervention with corticosteroids and immunosuppressants are essential for successful treatment. It also highlights the need for a multidisciplinary approach in the management of such patients, particularly in critical care settings.