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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
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Are you aware of drug induced-ANCA vasculitis associated with new wt loss medications (ex tirzepatide or semaglutide)?
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 do you approach tapering of tocilizumab used for a history of GCA with vision loss?
How do you approach the management of digital ischemia in a critically ill patient with infection, but no evidence of active rheumatologic disease?
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 would you manage a patient with ANCA associated vasculitis who has recurrent flare including pulmonary hemorrhage, persistent MPO antibody positivity while on maintenance rituximab and avacopan regimen even after induction rituximab therapy?
Would you start anticoagulation in a previously heathy patient with a new diagnosis of ANCA vasculitis (+PR3, RPGN, crescents on kidney biopsy) who presented with pancreatitis, splenic and renal infarcts and was also found to have CMV viremia?
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?
Do you always pursue biopsy confirmation before diagnosing IgA vasculitis?