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Eosinophilic granulomatosis with polyangiitis — SCE Rheumatology MCQ

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ModerateVasculitisEosinophilic granulomatosis with polyangiitisSCE Rheumatology

A 49-year-old woman with adult-onset asthma has weight loss, mononeuritis multiplex and purpuric rash. Eosinophils are 6.2 × 10^9/L, IgE is raised, chest CT shows transient infiltrates and MPO-ANCA is positive. What is the most likely diagnosis?

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Correct answer: C — Eosinophilic granulomatosis with polyangiitis

Asthma, marked eosinophilia, transient pulmonary infiltrates, neuropathy and vasculitic rash are characteristic of EGPA. GPA can cause ENT and lung disease but not this eosinophilic asthma phenotype. ANCA may be positive in EGPA, commonly MPO-ANCA, but the clinical phenotype is decisive.

Reference: BSR ANCA-associated vasculitis recommendations 2025; EULAR AAV recommendations