Eosinophilic Granulomatosis with Polyangiitis Presenting with an Acute Hypersensitivity Pneumonitis-like CT Pattern: A Case Report
Abstract
The patient was a man in his 20s with a history of childhood asthma who presented with fever and dyspnea. Chest CT revealed diffuse bilateral centrilobular ground-glass opacities, and a history of environmental exposure suggested acute hypersensitivity pneumonitis (HP). However, bronchoalveolar lavage revealed marked eosinophilia (75%), and a transbronchial lung biopsy demonstrated small vessel vasculitis with eosinophilic infiltration. Combined with negative anti-neutrophil cytoplasmic antibodies (ANCA), ANCA-negative eosinophilic granulomatosis with polyangiitis (EGPA) was diagnosed in this patient. Prednisolone (30 mg/day) resulted in rapid improvement, and remission was maintained for 6 months. This case shows that EGPA can mimic acute HP, underscoring the diagnostic value of bronchoscopy and histopathology when eosinophilic inflammation is present.
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BibTeX
@article{harada2026eosinophilic,
title = {{Eosinophilic Granulomatosis with Polyangiitis Presenting with an Acute Hypersensitivity Pneumonitis-like CT Pattern: A Case Report}},
author = {Shoichiro Harada and Yasuto Ueda and Shino Arita and Yuri Shibata and Takashi Sumikawa and Yasuyuki Hasegawa and Mizuho Matsushita and Hiroki Chikumi and Akira Yamasaki},
journal = {Internal Medicine},
year = {2026},
month = aug,
doi = {10.2169/internalmedicine.7786-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7786-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Eosinophilic Granulomatosis with Polyangiitis Presenting with an Acute Hypersensitivity Pneumonitis-like CT Pattern: A Case Report
AU - Shoichiro Harada
AU - Yasuto Ueda
AU - Shino Arita
AU - Yuri Shibata
AU - Takashi Sumikawa
AU - Yasuyuki Hasegawa
AU - Mizuho Matsushita
AU - Hiroki Chikumi
AU - Akira Yamasaki
PY - 2026
DA - 2026/08/08
JO - Internal Medicine
DO - 10.2169/internalmedicine.7786-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7786-26/_article
AB - The patient was a man in his 20s with a history of childhood asthma who presented with fever and dyspnea. Chest CT revealed diffuse bilateral centrilobular ground-glass opacities, and a history of environmental exposure suggested acute hypersensitivity pneumonitis (HP). However, bronchoalveolar lavage revealed marked eosinophilia (75%), and a transbronchial lung biopsy demonstrated small vessel vasculitis with eosinophilic infiltration. Combined with negative anti-neutrophil cytoplasmic antibodies (ANCA), ANCA-negative eosinophilic granulomatosis with polyangiitis (EGPA) was diagnosed in this patient. Prednisolone (30 mg/day) resulted in rapid improvement, and remission was maintained for 6 months. This case shows that EGPA can mimic acute HP, underscoring the diagnostic value of bronchoscopy and histopathology when eosinophilic inflammation is present.
SN - 1349-7235
SN - 0918-2918
ER -