Differentiating Churg-Strauss syndrome from other diseases: Difference between revisions
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== Diagnosis of Eosinophilic granulomatosis with polyangiitis == | == Diagnosis of Eosinophilic granulomatosis with polyangiitis == | ||
According to the American College of Rheumatology classification criteria <ref name="pmid2202307">{{cite journal| author=Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP et al.| title=The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). | journal=Arthritis Rheum | year= 1990 | volume= 33 | issue= 8 | pages= 1094-100 | pmid=2202307 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2202307 }}</ref> , in order to make a diagnosis of Eosinophilic granulomatosis with polyangiitis the following criteria must be present: | |||
* Asthma | * Asthma | ||
* Eosinophilia | * Eosinophilia | ||
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* Paranasal sinus that is abnormal | * Paranasal sinus that is abnormal | ||
* Eosinophil's that are extravascular | * Eosinophil's that are extravascular | ||
Patients must express 4 out the 6 criteria to be diagnosed with Eosinophilic granulomatosis with polyangiitis. | Patients must express 4 out the 6 criteria to be diagnosed with Eosinophilic granulomatosis with polyangiitis. | ||
Revision as of 16:49, 10 March 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]Associate Editor(s)-in-Chief: Krzysztof Wierzbicki M.D. [3]
Overview
Eosinophilic granulomatosis with polyangiits must be differentiated from other diseases that can cause purpura, alveolar hemorrhage, fever, arthralgia, myalgia, necrotizing extra-capillary glomerulonephritis, such as Granulomatosis with polyangiitis and Microscopic polyangiitis.[1]
Differentiating Eosinophilic granulomatosis with polyangiitis from other Diseases
Eosinophilic granulomatosis with polyangiitis must be differentiated from other diseases that cause purpura, alveolar hemorrhage, necrotizing extra-capillary glomerulonephritis, such as Granulomatosis with polyangiitis and Microscopic polyangiitis.[1]
| Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis serological findings | |||
|---|---|---|---|
| Eosinophilic granulomatosis with polyangiitis | Granulomatosis with polyangiitis | Microscopic polyangiitis | |
| Cytoplasmic ANCA (cANCA) | 90% positive | ||
| Perinuclear ANCA (pANCA) | 30 to 40% positive | 60 to 80% positive | |
| Myeloperoxidase antigen | † | † | |
| Proteinase 3 antigen | † | ||
Differentiating Eosinophilic granulomatosis with polyangiitis from other Diseases
Eosinophilic granulomatosis with polyangiitis must be differentiated from other diseases that cause pulmonary eosinophilia and perinuclear anti-neutrophil cytoplasmic antibodies (ANCA) such as:[2]
Pulmonary eosinophilia
- Parasitic infections
- Drugs
- Allergic bronchopulmonary aspergillosis
Perinuclear ANCA
- Cystic Fibrosis
- Bronchogenic carcinoma
- Inflammatory bowel disease
- Sclerosing cholangitis
- Myeloproliferative disorders
- Systemic lupus erythematosis
- Rheumatoid arthritis
Diagnosis of Eosinophilic granulomatosis with polyangiitis
According to the American College of Rheumatology classification criteria [3] , in order to make a diagnosis of Eosinophilic granulomatosis with polyangiitis the following criteria must be present:
- Asthma
- Eosinophilia
- Polyneuropathy or Mononeuropathy
- Non fixed pulmonary infiltrates
- Paranasal sinus that is abnormal
- Eosinophil's that are extravascular
Patients must express 4 out the 6 criteria to be diagnosed with Eosinophilic granulomatosis with polyangiitis.
References
- ↑ 1.0 1.1 Pagnoux C (2016). "Updates in ANCA-associated vasculitis". Eur J Rheumatol. 3 (3): 122–133. doi:10.5152/eurjrheum.2015.0043. PMID 27733943.
- ↑ Conron M, Beynon HL (2000). "Churg-Strauss syndrome". Thorax. 55 (10): 870–7. PMC 1745623. PMID 10992542.
- ↑ Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP; et al. (1990). "The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis)". Arthritis Rheum. 33 (8): 1094–100. PMID 2202307.