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Granulomatous inflammation (non-infectious)

Allergic granulomatosis and angiitis

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 22 October 2014, last major update September 2011
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● Also called Churg-Strauss syndrome
● Very rare
● Systemic vasculitis resembling polyarteritis nodosa or microscopic polyangiitis; associated with asthma, peripheral eosinophilia, pulmonary involvement and fever
● Rarely presents without pulmonary disease as fever of unknown origin
● < 50% have positive ANCA, often anti-myeloperoxidase


● Steroids: effective, but patients may relapse

Micro description

● Lung and extrapulmonary sites (skin, heart, nervous system, GI) have prominent eosinophilic infiltrate, granulomatous reaction around necrotic foci with radially arranged histiocytes and pallisading giant cells near small arteries or arterioles, eosinophilic vasculitis
● May have fibrin-rich edema, lymphocytes, sarcoid-like granulomas, focal fibrosis and eosinophilic microabscesses

Differential Diagnosis

Wegener granulomatosis:: kidney involvement, no asthma, no tissue or serum eosinophilia
Rheumatoid nodules: no tissue or serum eosinophilia, no asthma

End of Lung-nontumor > Granulomatous inflammation (non-infectious) > Allergic granulomatosis and angiitis

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