{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:04:07Z","timestamp":1784783047595,"version":"3.55.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":174,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Research Grants on Allergic Disease and Immunology"},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP22ek0410097"],"award-info":[{"award-number":["JP22ek0410097"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000646","name":"JSPS","doi-asserted-by":"publisher","award":["24K11593"],"award-info":[{"award-number":["24K11593"]}],"id":[{"id":"10.13039\/501100000646","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Environmental Restoration and Conservation Agency, Akita University Key Research Laboratory Fund","award":["202213003A"],"award-info":[{"award-number":["202213003A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The pathophysiology of organ involvement in eosinophilic granulomatosis with polyangiitis is characterised by vasculitis and eosinophilic inflammation, which can be accompanied by eosinophil extracellular trap cell death (EETosis). Clinically, eosinophilic inflammation is often observed in the lungs, gastrointestinal tract, and heart, whereas vasculitis more frequently affects the peripheral nerves, skin, and kidneys. However, histopathological confirmation of vasculitis and EETosis in different organs within the same patient has rarely been reported. We report a patient with EGPA presenting with both cutaneous and cardiac involvement. Skin biopsy findings were consistent with cutaneous fibrinoid vasculitis with prominent eosinophilic infiltration. Prednisolone therapy led to improvement of the skin lesion and inflammatory markers within 1\u00a0month. In contrast, endomyocardial biopsy demonstrated marked eosinophilic infiltration with cytolytic degranulation and extracellular deposition of eosinophil granule proteins, without evidence of fibrinoid vasculitis. Immunofluorescence findings supported the presence of EETosis. Despite prompt methylprednisolone pulse therapy, the cardiac lesion showed limited response and was complicated by refractory arrhythmias. This case suggests that distinct pathogenic mechanisms, namely vasculitis and EETosis, may predominate in different organs even within the same patient, potentially leading to discrepant treatment responses. When EETosis-driven pathology is dominant, conventional immunosuppressive therapy may have limited efficacy, highlighting the need for therapeutic strategies targeting EETosis.<\/jats:p>","DOI":"10.1093\/mrcr\/rxag046","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:21:26Z","timestamp":1782127286000},"source":"Crossref","is-referenced-by-count":0,"title":["Skin vasculitis and cardiac eosinophil extracellular trap formation in eosinophilic granulomatosis with polyangiitis: A case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3971-1327","authenticated-orcid":false,"given":"Hisashi","family":"Kamido","sequence":"first","affiliation":[{"name":"Nephrology Center, Toranomon Hospital Kajigaya , Kanagawa ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1494-3291","authenticated-orcid":false,"given":"Yuki","family":"Oba","sequence":"additional","affiliation":[{"name":"Nephrology Center, Toranomon Hospital Kajigaya , Kanagawa ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Yamanouchi","sequence":"additional","affiliation":[{"name":"Nephrology Center, Toranomon Hospital Kajigaya , Kanagawa ,","place":["Japan"]},{"name":"Nephrology Center, Toranomon Hospital , Tokyo ,","place":["Japan"]},{"name":"Okinaka Memorial Institute for Medical Research , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Suwabe","sequence":"additional","affiliation":[{"name":"Nephrology Center, Toranomon Hospital Kajigaya , Kanagawa ,","place":["Japan"]},{"name":"Nephrology Center, Toranomon Hospital , Tokyo ,","place":["Japan"]},{"name":"Okinaka Memorial Institute for Medical Research , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kono","sequence":"additional","affiliation":[{"name":"Department of Pathology, Toranomon Hospital , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Ohashi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Toranomon Hospital , Tokyo ,","place":["Japan"]},{"name":"Department of Human Pathology, Institute of Science Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keinosuke","family":"Hizuka","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine , Akita ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeharu","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine , Akita ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Sawa","sequence":"additional","affiliation":[{"name":"Nephrology Center, Toranomon Hospital Kajigaya , Kanagawa ,","place":["Japan"]},{"name":"Nephrology Center, Toranomon Hospital , Tokyo ,","place":["Japan"]},{"name":"Okinaka Memorial Institute for Medical Research , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshifumi","family":"Ubara","sequence":"additional","affiliation":[{"name":"Nephrology Center, Toranomon Hospital Kajigaya , Kanagawa ,","place":["Japan"]},{"name":"Nephrology Center, Toranomon Hospital , Tokyo ,","place":["Japan"]},{"name":"Okinaka Memorial Institute for Medical Research , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"2026072300410752000_ref1","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1038\/s41584-023-00958-w","article-title":"Evidence-Based Guideline for the diagnosis and management of eosinophilic granulomatosis with polyangiitis","volume":"19","author":"Emmi","year":"2023","journal-title":"Nat Rev Rheumatol"},{"key":"2026072300410752000_ref2","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1182\/blood-2012-05-432088","article-title":"Eosinophil extracellular DNA trap cell death mediates lytic release of free secretion-competent eosinophil granules in humans","volume":"121","author":"Ueki","year":"2013","journal-title":"Blood"},{"key":"2026072300410752000_ref3","doi-asserted-by":"crossref","first-page":"1145257","DOI":"10.3389\/fmed.2023.1145257","article-title":"Eosinophilic granulomatosis with polyangiitis \u2013 advances in pathogenesis, diagnosis, and treatment","volume":"10","author":"Fijolek","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"2026072300410752000_ref4","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1111\/1346-8138.16656","article-title":"Presence of eosinophil extracellular trap cell death in the affected skin of eosinophilic granulomatosis with polyangiitis","volume":"50","author":"Kawakami","year":"2023","journal-title":"J Dermatol"},{"key":"2026072300410752000_ref5","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/mrcr\/rxae046","article-title":"A case of eosinophilic granulomatosis with polyangiitis preceded by allergic bullous 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