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Case Reports
. 2023 Sep 2;13(5):50-56.
doi: 10.55729/2000-9666.1219. eCollection 2023.

Coronary Artery Dissection and Myocarditis Caused by Eosinophilic Granulomatosis with Polyangiitis (EGPA): A Case Report

Vidhyalakshmy Vivek #  1 , Sumeet Yadav #  2 , Hariprasad R Korsapati  2 , Mikael Mir  3 , Shika Jain  4 , Abbas B Jama  2 , Setu Trivedi  1 , Qiping Xu  2 , Namratha S Meda  5 , Syed Ali  1 , Anwar Khedr  6 , Esraa Hassan  2 , Noura Attallah  2 , Harsha Patnaik  7 , Sri U Jeevani Obulareddy  8 , Ibtisam Rauf  9 , Aishwarya R Korsapati  10 , Salim Surani  11 , Syed A Khan  2 , Nitesh K Jain  2 , Hasnain Bawaadam  1
Affiliations
Case Reports

Coronary Artery Dissection and Myocarditis Caused by Eosinophilic Granulomatosis with Polyangiitis (EGPA): A Case Report

Vidhyalakshmy Vivek et al. J Community Hosp Intern Med Perspect. .

Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) also referred to as Churg-Strauss syndrome is a rare vasculitis of the small to medium vessels. We present a rare case of acute coronary artery dissection brought on by EGPA, which generally has a poor prognosis. A 41-year-old male with history of bronchial asthma presented to the emergency room with a 2-week history of dyspnea, cough with clear phlegm, and fever. For the past eight months he had experienced episodes with similar symptoms relieved by steroids. CT chest showed bilateral upper lobe patchy opacities with extensive workup for infectious etiology being negative. He had peripheral eosinophilia with sinusitis. He had acute coronary syndrome and Coronary angiogram showed Right coronary artery dissection. After making a diagnosis of EGPA based on American college of Rheumatology criteria, he was successfully treated with high dose immunosuppression. Coronary artery dissection is a fatal and uncommon complication of EGPA which is usually diagnosed postmortem. Early recognition of this condition ante mortem and aggressive treatment can be lifesaving as demonstrated in our case.

Keywords: ANCA; Antineutrophil cytoplasmic antibody; Churg-Strauss syndrome; Coronary artery vasculitis; EGPA; Eosinophilic granulomatosis with polyangiitis; Glucocorticoids/therapeutic use; Granulomatosis with polyangiitis/diagnosis; Granulomatosis with polyangiitis/drug therapy; Humans; Immunosuppressive agents/therapeutic use; Vasculitis.

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Conflict of interest statement

Conflict of interest The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
A) Flow separation due to non-flow limiting dissection of mid to distal right coronary artery B) Long segment of diffuse disease involving distal vessel C) Partly occluded posterior descending artery.
See this image and copyright information in PMC

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References

    1. Chung SA, Langford CA, Maz M, et al. 2021 American college of rheumatology/vasculitis foundation guideline for the management of antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Care Res. 2021 Aug;73(8):1088–1105. doi: 10.1002/acr.24634. - DOI - PubMed
    1. Masi AT, Hunder GG, Lie JT, et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis) Arthritis Rheum. 1990 Aug;33(8):1094–1100. doi: 10.1002/art.1780330806. - DOI - PubMed
    1. Pakbaz M, Pakbaz M. Cardiac involvement in eosinophilic granulomatosis with polyangiitis: a meta-analysis of 62 case reports. J Tehran Heart Cent. 2020 Jan;15(1):18–26. - PMC - PubMed
    1. Comarmond C, Pagnoux C, Khellaf M, et al. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): clinical characteristics and long-term followup of the 383 patients enrolled in the French Vasculitis Study Group cohort. Arthritis Rheum. 2013 Jan;65(1):270–281. doi: 10.1002/art.37721. - DOI - PubMed
    1. Lin M, Su Z, Huang J, Li J, Luo N, Wang J. Eosinophilic granulomatosis with polyangiitis presenting with repetitive acute coronary syndrome, refractory coronary vasospasm, and spontaneous coronary dissection: a case report. J Int Med Res. 2022 Mar;50(3):3000605221089516. doi: 10.1177/03000605221089516. - DOI - PMC - PubMed

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