Case Report: sustained five-year remission in eosinophilic granulomatosis with polyangiitis with intestinal perforation after surgery and rituximab-based therapy without glucocorticoid escalation

1

Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis characterized by eosinophilic infiltration and granuloma formation.
2

Gastrointestinal involvement in EGPA occurs in approximately 23% of patients and can lead to severe complications like intestinal perforation.
3

Standard treatment for severe GI EGPA typically includes high-dose glucocorticoids combined with cyclophosphamide or rituximab.
4

A case study reported successful long-term remission of EGPA using rituximab without increasing glucocorticoid doses post-surgery.
5

The patient achieved sustained remission over five years with a gradual reduction of prednisolone from 17.5 mg/day to 1 mg/day.

Frontiers In Immunology

by Yuriko Yamamura, Yoshinori Matsumoto, Keiji Ohashi, Keigo Hayashi, Yoshia Miyawaki, Haruki Watanabe, Eri Katsuyama, Takayuki Katsuyama, Mariko Takano-Narazaki, Jun Wada
July 1, 2026

1