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Allergy and Airway: Asthma and Allergy |

Eosinophilic Granulomatosis With Polyangiitis (EGPA) Presenting With Difficult-to-Treat Asthma FREE TO VIEW

Qingling Zhang, PhD; Xu Shi, PhD; Rihuang Qiu, MD; Jiaxing Xie, PhD; Jing Li, PhD; Rongchang Chen, PhD
Author and Funding Information

State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital, Guangzhou, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A5. doi:10.1016/j.chest.2016.02.007
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SESSION TITLE: Asthma and Allergy

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, April 17, 2016 at 02:15 PM - 03:45 PM

PURPOSE: To improve the diagnosis of the Eosinophilic Granulomatosis with Polyangiitis (EGPA) with pulmonary involvement only from difficult-to-treat asthmatics

METHODS: We recruited 12 EGPA patients featured involvement of respiratory system only, 10 EGPA patients featured involvement of multiple systems or organs (including respiratory system, nervous system, skin, digestive system, heart, and kidney) and 122 difficult-to-treat asthmatics. The clinical data, including clinical manifestations, laboratory findings, and pathology were retrospectively investigated We recruited 12 EGPA patients featured involvement of respiratory system only, 10 EGPA patients featured involvement of multiple systems or organs (including respiratory system, nervous system, skin, digestive system, heart, and kidney) and 122 difficult-to-treat asthmatics. The clinical data, including clinical manifestations, laboratory findings, and pathology were retrospectively investigated

RESULTS: EGPA patients featured involvement of respiratory system only has no history of asthma and none of them had positive ANCA. The positive rate of ANCA in the EGPA patients featured involvement of multiple systems or organs was 10% (1/10). The percentage of eosinophils in sputum and blood, as well as the level of total IgE are higher in EGPA patients compared with difficult-to-treat asthmatics (p<0.05). EGPA patients featured involvement ofrespiratory system only with acute exacerbations had significant lower FEV1%pred and FVC%pred compared with diffictlt to treat asthmatics (48.1±22.9 vs. 68.1±22.7, 74.0±21.1 vs. 89.2±18.5, p<0.05). However, compared with difficult to treat asthmatics, EGPA patients featured involvement of respiratory system only had higher level of ΔFEV1 and ΔFVC after treatment (P<0.05). The CT scan was abnormal in both EGPA groups. Both EGPA groups showed the similar change in the lung pathological manifestations, including eosinophilic infihration in bronchial mucosa, alveolar space and pulmonary mesenchyme. Eosinophils infiltration in intravascular and extravascular presented in some EGPA patients.

CONCLUSIONS: EGPA patients featured involvement of respiratory system only has similar clinical presentations as EGPA patients featured involvement of multiple systems which is different from difficult-to-treat asthma. Early diagnosis for EGPA should be made from difficult-to-treat asthma. It will be helpful for a better prognosis.

CLINICAL IMPLICATIONS: To improve the diagnosis of the EGPA, It will be helpful for a better prognosis.

DISCLOSURE: The following authors have nothing to disclose: Qingling Zhang, Xu Shi, Rihuang Qiu, Jiaxing Xie, Jing Li, Rongchang Chen

No Product/Research Disclosure Information


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