Eosinophilic granulomatosis with polyangiitis associated with hepatitis B virus: Diagnostic and therapeutic challenges (a clinical case report)
https://doi.org/10.47360/1995-4484-2026-99-103
Abstract
The present article describes a rare clinical case of eosinophilic granulomatosis with polyangiitis in a 63-year-old patient presenting with polyneuropathy, marked weight loss, and vasculitis rash on the lower extremities. In addition to the primary disease, the patient had a history of active chronic hepatitis B virus infection, drawing attention to a possible association between viral infection and the development of vasculitis. The pathophysiological mechanisms underlying the development of polyneuropathy in this patient are discussed, along with the therapeutic approach involving glucocorticoids and azathioprine, which led to clinical stabilization. The article emphasizes the importance of comprehensive diagnostic evaluation and a differential therapeutic strategy, particularly in the context of coexisting viral hepatitis and autoimmune disease.
About the Authors
L. K. Babayeva
Absheron Central District Hospital
Azerbaijan
Competing Interests:
Azerbaijan
Leman K. Babayeva
AZ0100, Khyrdalan, Galubiye str, 12
Competing Interests:
None
F. N. Gasimova
Azerbaijan State Advanced Training Institute for Doctors named after A. Aliyev
Azerbaijan
Competing Interests:
Azerbaijan
AZ1012, Baku, Muzaffara Hasanova str., 35
Competing Interests:
None
A. N. Bakhishova
Absheron Central District Hospital
Azerbaijan
Competing Interests:
Azerbaijan
AZ0100, Khyrdalan, Galubiye str, 12
Competing Interests:
None
I. M. Guliyeva
Central Hospital for Oilworkers
Azerbaijan
Competing Interests:
Azerbaijan
AZ1025, Baku, Yusifa Safarova str., 17A
Competing Interests:
None
G. H. Babayeva
Azerbaijan State Advanced Training Institute for Doctors named after A. Aliyev
Azerbaijan
Competing Interests:
Azerbaijan
AZ1012, Baku, Muzaffara Hasanova str., 35
Competing Interests:
None
References
1. Emmi G, Bettiol A, Gelain E, Bajema IM, Berti A, Burns S, et al. Evidence-based guideline for the diagnosis and management of eosinophilic granulomatosis with polyangiitis. Nat Rev Rheumatol. 2023;19(6):378-393. doi: 10.1038/s41584-023-00958-w
2. Churg J, Strauss L. Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am J Pathol. 1951;27(2):277-301.
3. Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL, et al. Nomenclature of systemic vasculitis. Proposal of an international consensus conference. Arthritis Rheum. 1994;37(2):187-192. doi: 10.1002/art.1780370206
4. Guchelaar NAD, Waling MM, Adhin AA, van Daele PLA, Schreurs MWJ, Rombach SM. The value of anti-neutrophil cytoplasmic antibodies (ANCA) testing for the diagnosis of ANCAassociated vasculitis, a systematic review and meta-analysis. Autoimmun Rev. 2021;20(1):102716. doi: 10.1016/j.autrev.2020.102716.
5. Qasim A, Patel JB. ANCA-associated vasculitis. Treasure Island (FL):StatPearls Publishing;2025
6. Anaev EKh, Belevskiy AS, Kniajeskaia NP. Eosinophilic granulomatosis with polyangiitis: Etiopathogenesis, classification and clinical phenotypes. Pulmonologiya. 2023;33(3):393- 400 (In Russ.). doi:10.18093/0869-0189-2022-4101
7. Walulik A, Łysak K, Błaszkiewicz M, Górecki I, Gomułka K. The role of neutrophils in ANCA-associated vasculitis: The pathogenic role and diagnostic utility of autoantibodies. Int J Mol Sci. 2023;24(24):17217. doi: 10.3390/ijms242417217.
8. Chen M, Kallenberg CGM, Zhao M-H. ANCA-negative pauciimmune crescentic glomerulonephritis. Nat Rev Nephrol. 2009;(5):313-3188. doi: 10.1038/nrneph. 2009.67.
9. Pagnoux C. Updates in ANCA-associated vasculitis. Eur J Rheumatol. 2016;3(3):122-133. doi: 10.5152/eurjrheum.2015.0043.
10. Nguyen Y, Guillevin L. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss). Semin Respir Crit Care Med. 2018;39(4):471-481. doi: 10.1055/s-0038-1669454.
11. Bantis K, Stangou MJ, Kalpakidis S, Nikolaidou C, Lioulios G, Mitsoglou Z, et al. Different types of ANCA determine different clinical phenotypes and outcome in ANCA-associated vasculitis (AAV). Front Med (Lausanne), 2022;8:783757. doi: 10.3389/fmed.2021.783757
12. Fijolek J, Radzikowska E. Eosinophilic granulomatosis with polyangiitis – Advances in pathogenesis, diagnosis, and treatment. Front Med (Lausanne). 2023;3(10):1145257. doi:10.3389/fmed.2023.1145257
13. Rout P, Maher L. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss Syndrome) Treasure Island (FL):StatPearls Publishing;2025. https://www.ncbi.nlm.nih.gov/books/NBK537099/
14. Goldfarb JM, Rabinowitz MR, Basnyat S, Nyquist GG, RosenMR. Head and neck manifestations of eosinophilic granulomatosis with polyangiitis: A systematic review. Otolaryngol Head Neck Surg. 2016;155(5):771-778. doi: 10.1177/0194599816657044.
15. White J, Dubey S. Eosinophilic granulomatosis with polyangiitis: A review. Autoimmun Rev. 2022;22:103219. doi: 10.1016/j.autrev.2022.103219
16. Vega Villanueva K, Espinoza L. Eosinophilic vasculitis. Cur Rheumatol Rep. 2020;(22):5. doi: 10.1007/s11926-020-0881-2
17. Comarmond C, Pagnoux C, Khellaf M, Cordier JF, Hamidou M, Viallard JF, et al.; French Vasculitis Study Group. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): Clinical characteristics and long-term follow-up of the 383 patients enrolled in the French Vasculitis Study Group cohort. Arthritis Rheum. 2013;65(1):270-281. doi: 10.1002/art.37721
18. Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Ruoppolo G, et al. Churg-Strauss syndrome. Autoimmun Rev. 2015;14(4):341-348. doi: 10.1016/j.autrev.2014.12.004
19. Hwang JP, Lok AS. Management of patients with hepatitis B who require immunosuppressive therapy. Nat Rev Gastroenterol Hepatol. 2014;11(4):209-219. doi: 10.1038/nrgastro.2013.216
20. Kaeley N, Kamakshi N. Eosinophilic granulomatosis with polyangiitis (EGPA) and hepatitis B infection – A rare association. J Clin Diagn Res. 2016;10(12):OD07-OD09. doi: 10.7860/JCDR/2016/20181.9067
Review
For citations:
Babayeva L.K., Gasimova F.N., Bakhishova A.N., Guliyeva I.M., Babayeva G.H. Eosinophilic granulomatosis with polyangiitis associated with hepatitis B virus: Diagnostic and therapeutic challenges (a clinical case report). Rheumatology Science and Practice. 2026;64(1):99-103. (In Russ.) https://doi.org/10.47360/1995-4484-2026-99-103
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