Eosinophilic granulomatosis with polyangitis (eGPA)

Summary: • Eosinophilic granulomatosis with polyangitis (eGPA or Churg-Strauss) o Presentation key features: > Orbital inflammatory syndrome • Redness, pain, lid edema, diplopia, ophthalmoplegia, optic neuropathy > Vasculitis-like presentation • Stroke o Past medical history > asthma o American College of Rheumatology diagnostic criteria include: > Asthma > Eosinophilia (>10% in peripheral blood evident on CBC with differential) > Mononeuritis multiplex or polyneuropathy > Pulmonary infiltrates on chest x-ray (non-specific, patchy) > Paranasal sinusitis > Mononeuritis multiplex or polyneuropathy > Biopsy specimen • Might show histological proof of vasculitis with eosinophils o Summary: the key differentiating feature of eGPA is eosinophilia > Add to differential in patient with history of asthma with neuro-ophthalmic complaint> Work up with a chest x-ray, CBC with differential, ANCA, imaging of head/orbit and biopsy