From Anti-Neutrophil Cytoplasmic Antibody-Negative to Positive: Eosinophilic Granulomatosis with Polyangiitis Under Benralizumab After Steroid Cessation

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IŞIK Ş., YILMAZ İ., TÜRK M., Acar E., Alpsoy H. P.

JOURNAL OF CLINICAL PRACTICE AND RESEARCH, cilt.48, sa.1, ss.87-91, 2026 (ESCI, TRDizin)

Özet

Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis characterized by asthma, eosinophilia, and small-to medium-vessels inflammation. Case Report: We present the case of a 28-year-old woman with severe eosinophilic asthma, chronic rhinosinusitiswith nasal polyposis,and recurrent pruritic skin lesions. Shewasdiagnosed 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. Conclusion: This case highlights the importance of close ANCA monitoring and increased awareness of skin manifestations in patients treated with benralizumab in whom systemic corticosteroids can be discontinued.