Noninfectious granulomatous inflammation

Allergic granulomatosis and angiitis

Topic Completed: 1 September 2011

Minor changes: 12 April 2021

Copyright: 2003-2021,, Inc.

PubMed search: allergic [title] granulomatosis angiitis pulmonary

Elliot Weisenberg, M.D.
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Cite this page: Weisenberg E. Allergic granulomatosis and angiitis. website. Accessed October 28th, 2021.
Definition / general
  • 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 antimyeloperoxidase
  • Steroids: effective, but patients may relapse
Microscopic (histologic) 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
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