title: Childhood-onset eosinophilic granulomatosis with polyangiitis: a rare childhood vasculitis mimicking anthrax and eosinophilic leukaemia.
abstract: A 14-year-old boy previously misdiagnosed as having cutaneous anthrax was referred with a 2-month history of multiple wide and deep ulceronecrotic lesions in the lower extremities, which occurred after contact with animals. Skin biopsy was compatible with vasculitis. Further examination at our hospital elicited eosinophilia and a history of asthma. On the second day of hospitalisation, he developed deep vein thrombosis. A diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA) was established and intravenous methylprednisolone was administered. The patient showed remarkable improvement of the cutaneous lesions. Diagnosis of EGPA is challenging in the vasculitic phase and necessitates a detailed history that specifically questions the patient for an asthma background. This case illustrates a severe cutaneous presentation of EGPA and emphasises the difficulty of diagnosis as a result of overlapped signs and symptoms with cutaneous anthrax and leukaemia. EGPA should be kept in mind in the differential diagnosis of cutaneous lesions associated with eosinophilia.
authors.affiliation: Department of Pediatric Rheumatology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Sezgin
authors.initials: S
authors.lastname: Sahin
authors.affiliation: Department of Pediatric Rheumatology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Amra
authors.initials: A
authors.lastname: Adrovic
authors.affiliation: Department of Pediatric Rheumatology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Barut
authors.affiliation: Department of Pediatric Rheumatology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Kasapcopur
mesh_terms: D000293:Adolescent; D000881:Anthrax / Q000150:complications / Q000175:diagnosis*; D015267:Churg-Strauss Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications / Q000175:diagnosis*; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D017192:Skin Diseases, Bacterial / Q000150:complications / Q000175:diagnosis*; D012883:Skin Ulcer / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone