Case Report: Severe ANCA-positive eosinophilic granulomatosis with polyangiitis presenting with Loeffler endocarditis and cryofibrinogenemia-associated digital gangrene successfully treated with rituximab - Scorecard - MDSpire

Case Report: Severe ANCA-positive eosinophilic granulomatosis with polyangiitis presenting with Loeffler endocarditis and cryofibrinogenemia-associated digital gangrene successfully treated with rituximab

  • By

  • Irena Ostric Pavlovic

  • Danijela Trifunovic-Zamaklar

  • Branka Bonaci-Nikolic

  • Mileva Bascarevic

  • Vesna Tomic-Spiric

  • Aleksandra Peric-Popadic

  • Natasa Dragasevic Miskovic

  • Boris Ukropina

  • Aleksandar Reljic

  • Natasa Kusic

  • Andrija Pavlovic

  • Antonije Velickovic

  • Sara Radovic

  • Snezana Arandjelovic

  • July 7, 2026

  • 0 min

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Clinical Scorecard: Case Study: Successful Management of Severe ANCA-positive Eosinophilic Granulomatosis with Polyangiitis Complicated by Loeffler Endocarditis and Cryofibrinogenemia-related Digital Gangrene Using Rituximab

At a Glance

CategoryDetail
ConditionEosinophilic Granulomatosis with Polyangiitis (EGPA)
Key MechanismsType-2 immune response mediated by Th2 lymphocytes and ANCA-mediated vasculitis.
Target PopulationAdults, particularly those with asthma and eosinophilia.
Care SettingClinical management of systemic vasculitis.

Key Highlights

  • EGPA is characterized by asthma, eosinophilia, and small-to-medium vessel inflammation.
  • The case involved severe ischemic complications including digital gangrene and Loeffler endocarditis.
  • Rituximab treatment led to positive clinical and biochemical responses.
  • The patient achieved sustained remission with a combination of therapies.

Guideline-Based Recommendations

Diagnosis

  • Diagnosis based on clinical history, eosinophilia, and ANCA positivity.

Management

  • Initiation of B-cell targeted therapy with rituximab for severe cases.

Monitoring & Follow-up

  • Regular follow-up for disease activity and treatment response.

Risks

  • Potential for severe ischemic complications and multi-organ involvement.

Patient & Prescribing Data

37-year-old female with severe EGPA and associated complications.

Combination therapy included rituximab, corticosteroids, and methotrexate.

Clinical Best Practices

  • Early recognition of EGPA symptoms is critical for timely intervention.
  • Consideration of B-cell targeted therapies in severe cases.

Related Resources & Content

Original Source(s)

Case Report: Severe ANCA-positive eosinophilic granulomatosis with polyangiitis presenting with Loeffler endocarditis and cryofibrinogenemia-associated digital gangrene successfully treated with rituximab

  • by Irena Ostric Pavlovic, Danijela Trifunovic-Zamaklar, Branka Bonaci-Nikolic, Mileva Bascarevic, Vesna Tomic-Spiric, Aleksandra Peric-Popadic, Natasa Dragasevic Miskovic, Boris Ukropina, Aleksandar Reljic, Natasa Kusic, Andrija Pavlovic, Antonije Velickovic, Sara Radovic, Snezana Arandjelovic

  • July 7, 2026

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