Two Cases of Eosinophilic Granulomatosis With Polyangiitis Presenting With Rhinologic Manifestations

Eosinophilic granulomatosis with polyangiitis (EGPA) frequently presents with asthma and sinusitis, making otorhinolaryngologic manifestations potential early indicators of systemic vasculitis. However, these manifestations are often misdiagnosed as common inflammatory diseases. We report two cases of EGPA diagnosed based on distinct rhinologic presentations. The first case involved a 52-year-old woman who developed mononeuritis multiplex and cutaneous vasculitis following surgery for nasal polyps, which ultimately led to a definitive diagnosis of EGPA. The second case involved a 39-year-old woman who presented with nasal septal perforation and was subsequently diagnosed with an acute exacerbation of EGPA accompanied by pulmonary infiltrates. These cases highlight that not only nasal polyps but also atypical findings, such as nasal septal perforation, may serve as critical diagnostic clues for EGPA. Otorhinolaryngologists play a pivotal role in identifying this potentially fatal systemic vasculitis through careful evaluation of localized sinonasal manifestations.