DOI: https://doi.org/10.36347/sjmcr.2025.v13i07.029

Pages: 1637-1639

Introduction: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare small-vessel vasculitis characterised by asthma, eosinophilia, and systemic involvement. Its association with coeliac disease (CD) is extremely rare but may share common immunological mechanisms. Case presentation: A 57-year-old woman with asthma presented with fixed purpuric and pruritic plaques, digestive symptoms, and distal paraesthesias. She had marked hypereosinophilia (6 000 cells/μL), eosinophilic vasculitis on skin biopsy, and axonal polyneuropathy. Further investigations revealed subtotal villous atrophy and positive coeliac serology, confirming coeliac disease. Treatment with corticosteroids and a gluten-free diet led to a favourable outcome. Discussion: This case illustrates how hypereosinophilia can serve as a clinical bridge between EGPA and coeliac disease. The coexistence of both conditions likely reflects a shared Th2-driven immunopathogenesis. Identifying this overlap is crucial for guiding both immunosuppressive and dietary management. Conclusion: In patients with unexplained hypereosinophilia and multisystem involvement, the combination of EGPA and coeliac disease, though rare, should be considered.