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Topics:
Rheumatology
•
Vasculitis
How would you approach a patient with EGPA, with main manifestations of asthma, nasal polyposis, and mononeuritis multiplex, who has clinically responded to rituximab, yet has persistently high eosinophilia (>40%)?
Would you add mepolizumab for the eosinophilia?
Related Questions
How would you approach failure of maintenance therapy (Azathioprine) for PR3 positive, c-ANCA positive, pulmonary–renal vasculitis previously induced with cyclophosphamide, with a history of anaphylaxis to rituximab?
How would you approach the workup of a female patient who has recurrent sinusitis with polyps (biopsy showed active and chronic inflammation) and myocarditis, but negative ANCA and normal eosinophil counts?
How do you approach worsening memory loss in patients with GCA?
Do you always pursue biopsy confirmation before diagnosing IgA vasculitis?
What would be your approach to managing severe ANCA-associated vasculitis in a patient who is also septic from a bacterial infection?
What is your approach to treating IgA nephropathy in patients who also have IgA vasculitis?
Would you consider re-dosing rituximab in a patient with ANCA vasculitis (early glomerulonephritis, pulmonary nodules, sinus symptoms) who experiences a flare of the disease and return of CD19 cells 3 months after initial rituximab administration?
How do you approach tapering of tocilizumab used for a history of GCA with vision loss?
Would you add a DMARD such as methotrexate for a patient with GCA and partial response to tocilizumab but inability to taper prednisone below 10mg daily?
What treatment regimen would you recommend for a patient with biopsy-proven giant cell arteritis and diffuse cutaneous systemic sclerosis?