Therapeutic Objective Risk reduction or prevention of complications. Therapy recommendations Therapy of bronchial asthma – see there! Therapy is based on the number of eosinophils (should be less than 700/ml). Cortisone therapy alone is indicated in the absence of cardiac involvement or severe inflammation of the peripheral nervous system. In case of manifestation in the … Eosinophilic Granulomatosis with Polyangiitis: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Abdominal ultrasonography (ultrasound examination of the abdominal organs) – for basic diagnostics. X-ray of the thorax (X-ray thorax/chest), in two planes – to detect infiltrations. Electrocardiogram (ECG; recording of … Eosinophilic Granulomatosis with Polyangiitis: Diagnostic Tests
The following symptoms and complaints may indicate eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg-Strauss syndrome (CSS): Allergic symptomatology such as allergic asthma (in 70% of cases), allergic rhinitis (hay fever). Involvement internal organs, especially heart (in about 30% of cases; ANCA usually negative and high eosinophil counts, eosinophilic granulomatous myocarditis (inflammation of the heart muscle), … Eosinophilic Granulomatosis with Polyangiitis: Symptoms, Complaints, Signs
Pathogenesis (disease development) The etiology (causes) of eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg-Strauss syndrome (CSS), is unknown. Genetic factors, the complement system, B- and T-cell response, involvement of cytokines, and endothelial changes are thought to be important with regard to pathogenesis. Infectious triggers are also discussed as triggers. Neutrophils, B cells, and ANCA (antineutrophil … Eosinophilic Granulomatosis with Polyangiitis: Causes
Musculoskeletal system and connective tissue (M00-M99). Other vasculitides (inflammatory rheumatic diseases characterized by a propensity for inflammation of (usually) arterial blood vessels) Neoplasms – tumor diseases (C00-D48). Hypereosinophilic syndrome – chronic eosinophilic leukemia.
The following are the major diseases or complications that may be contributed to by eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg-Strauss syndrome (CSS): Respiratory System (J00-J99) Pulmonary syndrome – combination of renal and pulmonary vasculitis (inflammation of the (mostly) arterial blood vessels in the kidneys and lungs), including necrotizing extracapillary proliferative glomerulonephritis (inflammation of the … Eosinophilic Granulomatosis with Polyangiitis: Complications
Activity stages of ANCA-associated vasculitides (AAV) – EUVAS definition. Activity stage Definition Localized stage Upper and/or lower respiratory tract without systemic manifestation, without B symptoms, not organ-threatening1 Early systemic stage All organ involvement possible, not life-threatening or organ-threatening2 Generalization stage Renal involvement (kidney involvement) or other organ-threatening manifestation (serum creatinine < 500 µmol/l (5.6 mg/dl))3 … Eosinophilic Granulomatosis with Polyangiitis: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Gait pattern [muscular discomfort, jumping joint pain]. Abdomen (abdomen) Shape of the abdomen? Skin color? Skin … Eosinophilic Granulomatosis with Polyangiitis: Examination
1st order laboratory parameters – obligatory laboratory tests. Blood count – eosinophilia [increase in the number of eosinophilic granulocytes, in blood and affected organs]. Inflammatory parameters – CRP (C-reactive protein). Total IgE [↑] Alkaline phosphatase (AP) [possibly ↑] Autoimmune serology: PANCA (perinuclear antineutrophil cytoplasmic antibodies) (in only 40% of cases)Note: Histological confirmation of the diagnosis … Eosinophilic Granulomatosis with Polyangiitis: Test and Diagnosis
Medical history (history of illness) represents an important component in the diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg-Strauss syndrome (CSS). Family history What is the general health status of your family members? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What … Eosinophilic Granulomatosis with Polyangiitis: Medical History
