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EGPA neuropathy — SCE Rheumatology MCQ

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ModerateVasculitisEGPA neuropathySCE Rheumatology

A 43-year-old woman with EGPA develops foot drop and worsening asthma. Examination shows purpura and mononeuritis multiplex are present. Investigations show eosinophils are 3.4 x 10^9/L. What is the most appropriate management?

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Correct answer: E — Systemic glucocorticoid plus immunosuppression for organ-threatening disease

Systemic glucocorticoid plus immunosuppression for organ-threatening disease is the best management step because the vignette describes active or organ-threatening vasculitis. The tempting alternatives either delay sight- or organ-saving therapy or treat a different condition. In vasculitis, treatment urgency is determined by organ threat as much as by diagnostic certainty.

Reference: EULAR ANCA-associated vasculitis recommendations; BSR guideline; BNF