A Case of Eosinophilic Granulomatosis With Polyangiitis Presenting With Conjunctival Lesions During Treatment With IL-5 Inhibitors.

Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic rheumatic disease characterized by necrotizing vasculitis in the small vessels with eosinophilic inflammation. EGPA involves multiple organs, such as the heart, lungs, kidneys, gastrointestinal tract, nerves, and ophthalmic organs. Ophthalmic involvement includes conjunctival nodules, orbital myositis, orbital inflammatory syndrome, dacryoadenitis, and cranial nerve palsy. Notably, conjunctival nodules in patients with EGPA are very rare lesions but may present with atypical eyelid swelling. Herein, we present a case of EGPA with bilateral conjunctival nodules that developed during treatment with Interleukin (IL)-5 inhibitors. This case highlights that EGPA may exhibit bilateral conjunctival lesions even during treatment with IL-5 inhibitors, suggesting incomplete suppression of T helper Type 2-associated immune pathways.