How would you approach an 80 year old patient with a history of pericardial effusion causing pericardial tamponade with peripheral eosinophilia, pANCA 1:1280 and MPO 139 but no other vasculitic phenomenon/renal dysfunction?

Would you try induction for EGPA with steroids and mepolizumab? Or Rituxan? I would like to avoid Cytoxan as she is frail and elderly. Is cardiac MRI necessary in this case?

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How would you approach an 80 year old patient with a history of pericardial effusion causing pericardial tamponade with peripheral eosinophilia, pANCA 1:1280 and MPO 139 but no other vasculitic phenomenon/renal dysfunction?

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