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Topics:
General Internal Medicine
•
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 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?
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 tocilizumab for treatment of GCA in patients with underlying CLL (not requiring therapy)?
How would you manage active psoriasis and psoriatic arthritis in patient on Rituximab and prednisone for MPO positive vasculitis?
What features on CTA/MRA are most helpful for differentiating large vessel vasculitis from atherosclerosis?
Would you stop azathioprine in a patient with ANCA vasculitis who has been in long term remission on azathioprine, but has a new diagnosis of lung cancer requiring initiation of immunotherapy?
How would you approach the workup and management of a young patient with recurrent biannual non-scarring oral ulcers and new onset neurologic symptoms with associated CNS white matter lesions concerning for Behcet’s?
How do you approach management of a young adult after ascending thoracic aneurysm repair with biopsy showing granulomatous inflammation (no other vascular involvement, PET scan normal)?
Do you avoid tocilizumab in patients with prior bariatric surgery given the risk of GI perforation?
Are there patients with granulomatosis with polyangiitis on maintenance rituximab therapy for whom you do not co-administer glucocorticoid therapy?