@article{10902/35910,
year = {2024},
url = {https://hdl.handle.net/10902/35910},
abstract = {Background: Eosinophilic granulomatosis with polyangiitis (EGPA), is a rare ANCA-associated systemic vasculitis. Its overlapping features with other vasculitic or eosinophilic diseases, and the wide and heterogeneous range of clinical manifestations, often result in a delay to diagnosis.
Objective: To identify red flags that raise a suspicion of EGPA to prompt diagnostic testing and to present an evidence-based clinical checklist tool for use in routine clinical practice.
Methods: Systematic literature review and expert consensus to identify a list of red flags based on clinical judgement. GRADE applied to generate a strength of recommendation for each red flag and to develop a checklist tool.
Results: 86 studies were included. 40 red flags were identified as relevant to raise a suspicion of EGPA and assessed by the experts as being clinically significant. Experts agreed that a diagnosis of EGPA should be considered in a patient aged ?6 years with a blood eosinophil level >1000 cells/µL if untreated and >500 cells/µL if previously treated with any medication likely to have altered the blood eosinophil count. The presence of asthma and/or nasal polyposis should reinforce a suspicion of EGPA. Red flags of asthma, lung infiltrates, pericarditis, cardiomyopathy, polyneuropathy, biopsy with inflammatory eosinophilic infiltrates, palpable purpura, digital ischaemia and ANCA positivity, usually anti-myeloperoxidase, among others, were identified.
Conclusion: The identification of a comprehensive set of red flags could be used to raise a suspicion of EGPA in patients with eosinophilia, providing clinicians with an evidence-based checklist tool that can be integrated into their practice.},
organization = {The present work was funded by GSK. Authors were in full editorial control of the content and conclusions and accepted full responsibility for the final approval of the manuscript. The decision to submit for publication was taken solely by the authors and the sponsor did not place any restrictions on access to the data or on the statements made in the manuscript. GSK funded Adelphi Targis who undertook the literature research
and provided medical writing support under the direction and guidance of the expert authors. The authors were solely responsible for critical assessment and interpretation of results of the literature review and approved the final content.},
publisher = {Elsevier},
publisher = {European Journal of Internal Medicine, 2024, 128, 45-52},
title = {Red flags for clinical suspicion of eosinophilic granulomatosis with polyangiitis (EGPA)},
author = {Solans Laqué, R. and Rúa Figueroa, I. and Blanco Aparicio, M. and García Moguel, I. and Blanco Alonso, Ricardo and Pérez Grimaldi, F. and Noblejas Mozo, A. and Labrador Horrillo, M. and Álvaro Gracia, J.M. and Domingo Ribas, C. and Espigol Frigolé, G. and Sánchez Toril López, F. and Ortiz Sanjuán, F.M. and Arismendi, E. and Cid, M.C.},
}