Churg-Strauss syndrome diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
Diagnostic Study of Choice
- High resolution CT scan:
- High-resolution computerized tomography (HRCT) scan of patients with eosinophilic granulomatosis with polyangiitis will show the following findings:
- Airspace consolidations mostly bilateral and lobular distribution
- Ground-glass opacities, can be seen in a patchy or subpleural distribution, with inclination most commonly occurring in the lower zone portion of the lung
- Centrilobular nodules
- Bronchial wall thickening and/or dilatation
- Pleural effusions
- Hilar or mediastinal lymph node enlargement
- Interlobular septal thickening
- There are no established diagnostic tests to confirm the disease. However, bipsy may be considered for establishing diagnosis.
- Biopsy
- Because of the multiple organ involvements, the biopsy should be obtained from any of the following organ sites:
- Lung:
- The gold standard in establishing a diagnosis for eosinophilic granulomatosis with polyangiitis is a lung biopsy. surgical or transbronchial biopsy can be performed.
- Skin
- Nerve
- Kidney
- Muscle
- Lung:
- Biopsy findings may include eosinophilic infiltration, vasculitis of small and medium-sized vessels and granuloma formation.
- Because of the multiple organ involvements, the biopsy should be obtained from any of the following organ sites:
- Biopsy
Diagnostic Criteria
According to the American College of Rheumatology classification criteria [1]
| Asthma
Polyneuropathy or Mononeuropathy Non fixed pulmonary infiltrates Paranasal sinus that is abnormal Eosinophils that are extravascular |
Patients must express 4 out the 6 criteria to be diagnosed with eosinophilic granulomatosis with polyangiitis. |
According to Lanham diagnostic criteria [2]
| Asthma
Eosinophilia peak of >1.5x109 cell/L or >10% of the total WBC Systemic vasculitis, two or greater extra pulmonary sites |
All 3 criteria’s need to be present |
References
- ↑ 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.
- ↑ Lanham JG, Elkon KB, Pusey CD, Hughes GR (1984). "Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome". Medicine (Baltimore). 63 (2): 65–81. PMID 6366453.