Eosinophilic granulomatosis with polyangitis (EGPA; earlier called Churg-Strauss syndrome) is a small-vessel necrotising vasculitis typically characterised by asthma, lung infiltrates, extra-vascular necrotising granulomas and hyper-eosinophilia. Cardiac disease is a major contributor to disease-related deaths in EGPA. We describe the case of a 39-year-old woman with late onset asthma, allergic rhinosinusitis, and high extra-vascular and peripheral blood eosinophilia, presenting with peripheral neuropathy and pericardial effusion. Early therapy with intravenous corticosteroids led to resolution of the pericardial effusion and significant clinical improvement. The present case also highlights the importance of being vigilant about potentially fatal cardiac complications in patients with EGPA.
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