Churg-Strauss syndrome classification: Difference between revisions

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==Classification==
==Classification==
*According to the 1994 Chapel Hill consensus conference nomenclature of vasculitides, Eosinophilic granulomatosis with polyangiitis is described as an eosinophil-rich and granulomatous inflammation often involving the respiratory tract, and necrotizing vasculitis involving small to medium-sized arteries and venules, associated with asthma and eosinophilia.
*According to the 1994 Chapel Hill consensus conference , [[Eosinophilic granulomatosis with polyangiitis]] is described as an [[Eosinophil granulocyte|eosinophil]]-rich and granulomatous [[inflammation]] often involving the [[respiratory tract]], and necrotizing [[vasculitis]] involving small to medium-sized [[Artery|arteries]] and [[Venule|venules]], associated with [[asthma]] and [[eosinophilia]].
*The eponym Churg–Strauss syndrome, has been replaced during the 2012 Revised International Chapel Hill consensus conference, by mainly focusing on the histopathology of the disease. Eosinophilic Granulomatosis with Polyangiitis (formerly known as Churg-Strauss' syndrome) can be considered a variant of the ANCA associated vasculitides of the small vessels.<ref name="pmid23045170">{{cite journal |vauthors=Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, Flores-Suarez LF, Gross WL, Guillevin L, Hagen EC, Hoffman GS, Jayne DR, Kallenberg CG, Lamprecht P, Langford CA, Luqmani RA, Mahr AD, Matteson EL, Merkel PA, Ozen S, Pusey CD, Rasmussen N, Rees AJ, Scott DG, Specks U, Stone JH, Takahashi K, Watts RA |title=2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides |journal=Arthritis Rheum. |volume=65 |issue=1 |pages=1–11 |date=January 2013 |pmid=23045170 |doi=10.1002/art.37715 |url=}}</ref>
*The eponym Churg–Strauss syndrome, has been replaced during the 2012 Revised International Chapel Hill consensus conference, by mainly focusing on the histopathology of the disease. [[Eosinophilic granulomatosis with polyangiitis]] can be considered a variant of the [[Anti-neutrophil cytoplasmic antibody|ANCA]] associated [[vasculitis]] of the small vessels.<ref name="pmid23045170">{{cite journal |vauthors=Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, Flores-Suarez LF, Gross WL, Guillevin L, Hagen EC, Hoffman GS, Jayne DR, Kallenberg CG, Lamprecht P, Langford CA, Luqmani RA, Mahr AD, Matteson EL, Merkel PA, Ozen S, Pusey CD, Rasmussen N, Rees AJ, Scott DG, Specks U, Stone JH, Takahashi K, Watts RA |title=2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides |journal=Arthritis Rheum. |volume=65 |issue=1 |pages=1–11 |date=January 2013 |pmid=23045170 |doi=10.1002/art.37715 |url=}}</ref>
*The Revised International Chapel Hill Consensus Conference 2012 has stated that ANCA are found in eosinophilic granulomatosis with polyangiitis, particularly in patients with glomerulonephritis. This may suggest some of the new evidence of the distinction of EGPA subsets, depending on the presence or the absence of ANCA.
*The Revised International Chapel Hill Consensus Conference 2012 Nomenclature of Vasculitides has stated that [[Anti-neutrophil cytoplasmic antibody|anti-neutrophil cytoplasmic antibodies]] ([[Anti-neutrophil cytoplasmic antibody|ANCA]]) are found in [[eosinophilic granulomatosis with polyangiitis]], particularly in patients with [[glomerulonephritis]]. This may suggest some of the new evidence for the description of [[eosinophilic granulomatosis with polyangiitis]] subsets, depending on the presence or the absence of [[Anti-neutrophil cytoplasmic antibody|ANCA]].
*The Chapel Hill Consensus Conference, however, does not propose any diagnostic or classification criteria.
*The Chapel Hill Consensus Conference, however, does not propose any diagnostic or [[classification]] criteria.
*Therefore, the diagnostic criteria proposed by the American College of Rheumatology (ACR) in 1990 on Eosinophilic granulomatosis with polyangiitis is still being used to distinguish the disease. The presence of 4 out of the 6 diagnostic criteria has a reported sensitivity of 85% and a specificity of 99.7% for the diagnosis of Eosinophilic granulomatosis with polyangiitis.<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><ref name="pmid25404930">{{cite journal| author=Gioffredi A, Maritati F, Oliva E, Buzio C| title=Eosinophilic granulomatosis with polyangiitis: an overview. | journal=Front Immunol | year= 2014 | volume= 5 | issue=  | pages= 549 | pmid=25404930 | doi=10.3389/fimmu.2014.00549 | pmc=4217511 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25404930  }} </ref>
*Therefore, the diagnostic criteria proposed by the American College of Rheumatology (ACR) in 1990 on [[Eosinophilic granulomatosis with polyangiitis]] is still being used to distinguish the disease. The presence of 4 out of the 6 diagnostic criteria has a reported [[Sensitivity (tests)|sensitivity]] of 85% and a [[Specificity (tests)|specificity]] of 99.7% for the diagnosis of [[Eosinophilic granulomatosis with polyangiitis]].<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><ref name="pmid25404930">{{cite journal| author=Gioffredi A, Maritati F, Oliva E, Buzio C| title=Eosinophilic granulomatosis with polyangiitis: an overview. | journal=Front Immunol | year= 2014 | volume= 5 | issue=  | pages= 549 | pmid=25404930 | doi=10.3389/fimmu.2014.00549 | pmc=4217511 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25404930  }} </ref>
{| class="wikitable"
{| class="wikitable"
!American College of Rheumatology (ACR) Classification of Eosinophilic granulomatosis with polyangiitis
!American College of Rheumatology (ACR) Classification of Eosinophilic granulomatosis with polyangiitis

Revision as of 19:25, 29 March 2018

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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: Chandrakala Yannam, MD [3]

Overview

There is no established system for the classification of [disease name].

OR

[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].

OR

[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].

OR

Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.

OR

If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].

OR

The staging of [malignancy name] is based on the [staging system].

OR

There is no established system for the staging of [malignancy name].

Classification

American College of Rheumatology (ACR) Classification of Eosinophilic granulomatosis with polyangiitis
Asthma
Eosinophilia > 10%
Neuropathy (mononeuropathy or polyneuropathy)
Pulmonary infiltrate, non fixed
Paranasal sinus abnormality
Biopsy that shows extravascular eosinophil infiltration
  • There is no established system for the classification of [disease name].

OR

  • [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
    • [Group1]
    • [Group2]
    • [Group3]
    • [Group4]

OR

  • [Disease name] may be classified into [large number > 6] subtypes based on:
    • [Classification method 1]
    • [Classification method 2]
    • [Classification method 3]
  • [Disease name] may be classified into several subtypes based on:
    • [Classification method 1]
    • [Classification method 2]
    • [Classification method 3]

OR

  • Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.

OR

  • If the staging system involves specific and characteristic findings and features:
  • According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].

OR

  • The staging of [malignancy name] is based on the [staging system].

OR

  • There is no established system for the staging of [malignancy name].

References

  1. Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, Flores-Suarez LF, Gross WL, Guillevin L, Hagen EC, Hoffman GS, Jayne DR, Kallenberg CG, Lamprecht P, Langford CA, Luqmani RA, Mahr AD, Matteson EL, Merkel PA, Ozen S, Pusey CD, Rasmussen N, Rees AJ, Scott DG, Specks U, Stone JH, Takahashi K, Watts RA (January 2013). "2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides". Arthritis Rheum. 65 (1): 1–11. doi:10.1002/art.37715. PMID 23045170.
  2. 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.
  3. Gioffredi A, Maritati F, Oliva E, Buzio C (2014). "Eosinophilic granulomatosis with polyangiitis: an overview". Front Immunol. 5: 549. doi:10.3389/fimmu.2014.00549. PMC 4217511. PMID 25404930.

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