[A case of allergic granulomatous angitis with beneficial effects of plasma exchange]

A 54-year-old man had suffered from bronchial asthma, followed by numbness and muscle weakness of the extremities. He was admitted to our department in July, 1994, because of progression of the symptoms. On admission, neurological examination revealed muscle weakness with atrophy and sensory disturbance of multiple mononeuritic type. Blood tests revealed eosinophilia and an increase in rheumatoid factor, IgE levels and P-ANCA. A sural nerve biopsy showed necrotizing vasculitis and inflammation with eosinophil infiltration. The patient was diagnosed as having allergic granulomatous angitis,and treated with steroid pulse therapy without beneficial effect. Plasma exchange was performed twice, which resulted in remarkable improvement in motor and sensory disturbance. The present case suggests that plasma exchange has beneficial effects on severe cases with allergic granulomatous angitis.