Clinical features of eosinophilic granulomatosis with polyangiitis

Systemic features are common in eosinophilic granulomatosis with polyangiitis and include fever, anorexia and weight loss. Asthma is the most common respiratory feature, which is usually adult onset and difficult to control. Other common features include:

• pulmonary infiltrates and diffuse interstitial lung changes, including eosinophilic infiltration; see also Interstitial lung disease
• mononeuritis multiplex
• skin features—palpable purpura, skin infarcts, nodules over pressure areas
• coronary vasculitis or granulomatous infiltration of the myocardium—in up to 50% of cases; myocardial infarction and congestive cardiac failure are major causes of mortality
• glomerulonephritis—focal, segmental necrotising glomerulonephritis in approximately 20% of cases, often with crescent formation.

Diagnosis of eosinophilic granulomatosis with polyangiitis is based on a suggestive clinical picture, and supportive investigation findings.