Multisystem Eosinophilic Vasculitis with Cutaneous, Renal, and Enteric Involvement: A Case Report

Bologna C*, Criscuolo L, Solaro E, Salzillo M, Soriano A, Vinciguerra A, Scotto Di Luzio G, De Siero M, Orabona P and Tibullo L

Department of Internal Medicine, AORN Sant’Anna e San Sebastiano, Caserta, Italy
Department of Radiology Interventistion, AORN Sant’Anna e San Sebastiano, Caserta, Italy
Department of Anatomy Pathology, AORN Sant’Anna e San Sebastiano, Caserta, Italy

^*Correspondance to: Carolina Bologna 

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Abstract:

A 59-year-old male electrician presented to the Emergency Department with hematuria, severe asthenia, and an erythematous rash with desquamative lesions involving all photo-exposed areas, including the forehead, face, scalp, upper and lower limbs, and hands, which had appeared one week earlier. Laboratory tests revealed normochromic anemia requiring transfusion, marked eosinophilia (2,500/mm³), and severe acute kidney injury with creatinine of 16 mg/dL and BUN of 165 mg/dL, associated with metabolic acidosis. Although no peripheral edema was present, the patient showed mild dyspnea and tachypnea. Renal ultrasound showed increased cortical echogenicity suggestive of parenchymal damage, while chest CT demonstrated left lower lobe atelectasis and small mediastinal lymphadenopathy. The patient was admitted to the Internal Medicine ward for further evaluation. Autoimmune and rheumatologic screening, including C-ANCA, P-ANCA, ANA, and anti-dsDNA antibodies, was negative. Following nephrology consultation, hydration therapy led to partial improvement of renal function, after which a renal biopsy was performed. Histological findings were consistent with membranoproliferative glomerulonephritis, showing enlarged glomeruli, mesangial hypercellularity, and flocculocapsular adhesions. Dermatologic evaluation with skin biopsy revealed lichenoid dermatitis with neutrophilic and eosinophilic infiltration. Due to persistent diarrhea, endoscopic evaluation with colonic biopsy was carried out, demonstrating normal mucous glands with marked eosinophilic infiltration of the lamina propria. Based on multisystem involvement cutaneous, renal, and colonic the final diagnosis was eosinophilic vasculitis. High-dose corticosteroid therapy with prednisone (1 mg/kg/day) resulted in rapid clinical and laboratory improvement, with resolution of systemic symptoms and normalization of eosinophil counts. Corticosteroids were gradually tapered during follow-up without the need for immunosuppressive or biologic therapy.

Keywords:

Hypereosinophilia; Eosinophilic vasculitis; Acute renal failure; Glomerulonephritis.

Cite the Article:

Bologna C, Criscuolo L, Solaro E, Salzillo M, Soriano A, Vinciguerra A, et al. Multisystem Eosinophilic Vasculitis with Cutaneous, Renal, and Enteric Involvement: A Case Report. Clin Case Rep Int. 2026; 10: 1757..