A 32-year-old woman with long-standing asthma presents with fever, worsening cough with purulent sputum, and mononeuritis multiplex. Labs show eosinophils 18% (absolute count 2100/μL), IgE elevated. Chest X-ray shows bilateral migratory patchy infiltrates. p-ANCA is positive. Which combination fulfills the ACR/EULAR classification criteria for her diagnosis?
- A Asthma + eosinophils >10% + nasal polyposis
- B Asthma + eosinophils >10% + mononeuritis multiplex ✓
- C Asthma + mononeuritis multiplex + migratory pulmonary infiltrates
- D Eosinophils >10% + mononeuritis multiplex + glomerulonephritis
Correct answer: B. Asthma + eosinophils >10% + mononeuritis multiplex
Explanation
The diagnosis is eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss). The 2022 ACR/EULAR weighted criteria assign 3 points for asthma, 3 for eosinophils >10%, and 3 for mononeuritis multiplex, totaling 9 points (threshold ≥5 for classification). Nasal polyposis gives only 1 point. Migratory infiltrates give 2 points, and glomerulonephritis is not a weighted criterion in EGPA. Option B captures the three highest-yield features tested.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.