A Case of Allergic Granulomatous Angitis Accompanied by Colonic changes

A 43-year-old man had been suffering from recurrent attacks of bronchial asthma for 1 year. Two months prior to admission he reported aggravation of the symptoms, purpura on both his legs, weakened superficial sensation in his hands and fingers and watery stools, 8-times a day, accompanied by abdominal pain. He was admitted to our hospital to undergo careful examination. On admission, a peripheral blood test revealed high-level leukocytosis of 25,500/mm3 (eosinophiles, 57.3%) and increased IgE level of 2,990 U/mL. Based on these findings as well as the results of a skin biopsy, which showed eosinophilic vasculitis, a diagnosis of allergic granulomatous angitis (AGA) was made. Colon endoscopy revealed marginal flare with multiple erosions and ulceration in some parts of the sigmoid colon. After PSL therapy was initiated (60 mg/day) , the eosinophile count decreased to 5.1%, and the diarrhea and abdominal pain abated. Endoscopic examination performed after the treatment demonstrated a decreased number of mucosal erosions. PSL-dose tapering was stopped at 20 mg/day and, since no aggravation of symptoms was observed, the patient was discharged. In the present study, we report a case of colitis complicated with AGA we have encountered.