ArticleEuropean journal of case reports in internal medicine2026
Twenty Years of Undiagnosed Eosinophilia: Diabetic Attribution Bias Delaying Diagnosis of Anca-Positive EGPA Until End-Stage Organ Damage.
Article in European journal of case reports in internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Eosinophilic granulomatosis with polyangiitis (EGPA) has the longest diagnostic delay among anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides, with a reported median of 455 days. Cardiac disease, the leading cause of EGPA-related mortality, is largely preventable with early immunosuppression. Case description: A 53-year-old Hispanic woman with type 2 diabetes, hypertension, and no documented asthma had 20 years of persistent peripheral eosinophilia (absolute eosinophil count 1-2.7 ×10 Conclusion: This case illustrates how "diabetic attribution bias," care fragmentation, and socioeconomic barriers delayed EGPA diagnosis for 20 years despite persistent eosinophilia and progressive multi-organ damage. Systematic ANCA testing in patients with unexplained eosinophilia and organ involvement could prevent irreversible end-organ damage. LEARNING POINTS: Persistent unexplained eosinophilia (absolute eosinophil count >1 ×10
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