Which vasculitis is characterized by asthma and eosinophilia?

• A. Churg-Strauss
• B. Granulomatosis with polyangiitis
• C. Goodpasture syndrome
• D. Microscopic polyangiitis

Answer: (A)

Asthma and eosinophilia point to eosinophilic granulomatosis with polyangiitis, formerly known as Churg-Strauss. This small-to-medium vessel vasculitis classically begins with allergic symptoms like asthma and nasal involvement, followed by marked eosinophilia and then tissue inflammation with granulomatous vasculitis. Many patients have p-ANCA (MPO-ANCA). This distinguishes it from granulomatosis with polyangiitis, which often presents with chronic sinusitis and renal involvement and typically has c-ANCA (PR3-ANCA) with granulomatous inflammation; Goodpasture syndrome involves anti-GBM antibodies causing pulmonary hemorrhage and rapidly progressive glomerulonephritis without eosinophilia or asthma; microscopic polyangiitis features pauci-immune vasculitis with renal and pulmonary involvement but usually lacks asthma and eosinophilia.