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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?
Would you give IVIG for Rituximab induced immunodeficiency in patients with reduced kidney function from renal GPA?
How would you manage a patient with Takayasu arteritis controlled on TNFi who develops erythema nodosum that is only partially responsive to NSAIDs?
What is your approach to treating IgA nephropathy in patients who also have IgA vasculitis?
What would be your approach to managing severe ANCA-associated vasculitis in a patient who is also septic from a bacterial infection?
How would you approach the evaluation and management of isolated vasculitis with aneurysms involving the segmental hepatic arteries causing hepatic hemorrhage in an otherwise healthy patient in his 80s?
How would you approach a patient with high CRP, rising liver enzymes and new biopsy proven liver granulomas 6 months after starting methotrexate and Rituximab therapy for ANCA vasculitis?
How would you approach the treatment for patients with renal-limited ANCA vasculitis who have persistent proteinuria, hematuria, and ANCA titers and have completed a steroid taper and received three doses of rituximab?
Do you consider immunosuppression in a patient with cocaine-induced midline lesions who is ANCA positive, but has no other evidence of vasculitis?
What options are available for patients who require high dose steroids while taking strong CYP4A4 inducers?