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

To report a case of a patient with a rare presentation of eosinophilic granulomatosis with polyangiitis (EGPA) characterized by digital gangrene and Loeffler endocarditis.

Approach:
  • Case Presentation: A 37-year-old woman with EGPA presented with severe symptoms including digital necrosis and ischemic lesions despite previous treatments. Rituximab was initiated, leading to a positive clinical response.
Key Findings:
  • The patient had a combination of digital gangrene and Loeffler endocarditis associated with MPO-ANCA positivity and cryofibrinogenemia.
  • Rituximab treatment resulted in sustained remission and functional recovery over a three-year follow-up.
Interpretation:

This case presents a unique overlap of eosinophilic granulomatosis with polyangiitis, characterized by severe ischemic complications.

Limitations:
  • The rarity of the case limits generalizability.
  • Long-term outcomes beyond three years are not reported.
Conclusion:

This case highlights the importance of early recognition and targeted therapy in managing severe manifestations of EGPA.

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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