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FROM ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY-NEGATIVE TO POSITIVE: EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS UNDER BENRALIZUMAB AFTER STEROID CESSATION

Şilan IŞIK, İnsu YILMAZ, Murat TÜRK, Elif AÇAR, Hayrunnisa PEKTAŞ ALPSOY

Journal of Clinical Practice and Research - 2026;48(1):87-91

Division of Immunology and Allergy, Department of Pulmonology, Erciyes University Faculty of Medicine, Kayseri

 

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis characterized by asthma, eosinophilia, and small- to medium-vessels inflammation. We present the case of a 28-year-old woman with severe eosinophilic asthma, chronic rhinosinusitis with nasal polyposis, and recurrent pruritic skin lesions. She was diagnosed with EGPA based on the presence of asthma, peripheral eosinophilia, histopathologically confirmed vasculitis, and sinus-related involvement. Long-term corticosteroid therapy resulted in adverse effects, necessitating a transition to mepolizumab and subsequently to benralizumab. Although systemic corticosteroids were successfully discontinued under benralizumab therapy, the patient developed pruritic papular-plaque skin lesions in the eighth month of treatment. Laboratory evaluation revealed new-onset perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) positivity despite normal eosinophil counts.