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

  • 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
    • Biopsy findings may include eosinophilic infiltration, vasculitis of small and medium-sized vessels and granuloma formation.

Diagnostic Criteria

According to the American College of Rheumatology classification criteria [1]

Asthma

Eosinophilia

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

  1. 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.
  2. 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.

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