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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
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?
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 management of a patient with mixed cryoglobulinemic vasculitis with predominant skin involvement and no major organ involvement?
How would you approach management of a young woman referred for isolated active anterior scleritis with a history of resolved right eye iritis, in the absence of systemic manifestations or end-organ involvement, but with serologies notable for strongly positive MPO and p-ANCA antibodies?
What strategies do you use when initiating treatment for complex livedoid vasculitis in a patient you cannot follow long-term, especially when therapy is limited to conservative measures due to medication contraindications?
How do you treat IgA vasculitis with gastrointestinal involvement?
Have you seen microscopic polyangiitis associated with temporal artery involvement?
Would you consider switching to benralizumab for patients with EGPA experiencing severe pulmonary symptoms despite being on mepolizumab?
What options are available for patients who require high dose steroids while taking strong CYP4A4 inducers?
Would you consider anti-IL-5 therapy (mepolizumab or benralizumab) to either prevent or treat the more severe manifestations of eosinophilic granulomatosis with polyangiitis, such as "infiltrative" (e.g., cardiomyopathy, pulmonary infiltrates, or gastroenteritis) or "vasculitic" (e.g., neuropathy, palpable purpura, or glomerulonephritis)?