POS-161 A CASE OF EGPA THAT DEVELOPED DURING REMISSION OF IGA NEPHROPATHY

Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis that affects small and medium sized vessels. EGPA also characterized by allergic rhinitis, asthma, prominent peripheral blood eosinophilia. rare disease, its prevalence about 11-13 cases per million. On the other hand, IgA nephropathy most common disease found to cause primary glomerulonephritis all over world. There has been no case report of who had history nephropathy. We conducted PubMed literature search using key words (eosinophilic or Churg-Strauss) (IgA nephropathy), from 1986 2020. No was identified. A 54-year-old woman diagnosed have kidney biopsy when she 25 years old 1.0 g/day proteinuria. remission achieved prednisolone, maintained under immunosuppressant for years. 7 ago, moved follow up started at our hospital. At first visit, serum creatinine (sCr) 0.53 mg/dl, eGFR 95 ml/min/1.73m2, MPO-ANCA negative in test. Urine protein occult were urinalysis. Afterward, sCr kept around 0.5-0.7 urine treatment angiotensin II receptor blocker. 10 months newly developed asthma. 6 eosinophilia appeared. 2 increase, finally reaching 3+. levels stable 0.1-0.3 g/gCr. presentation, elevated 0.85 became positive (85.9 U/ml), 2000μl. symptoms. renal biopsy, because we suspected EGPA. In there cellular crescents necrotic arteritis, neither eosinophil infiltration nor granuloma increased mesangial endocapillary hypercellularity. By immunofluorescence, significant deposits IgA. 2012 Revised International Chapel Hill Consensus Conference Nomenclature Vasculitides (CHCC2012) definition. selected combination therapy prednisolone cyclophosphamide thought severity severe. As induction therapy, administered methylprednisolone pulse (1000 mg/day), followed prednisone 0.8 mg/kg/day, gradual tapering. addition, used intravenous (IV) (500 mg/body) every weeks 4 times. after second IV pulse. maintenance are going switch azathioprine. To knowledge, this during status The importance screening association reaffirmed new symptoms appear body.