Background
Clinical Manifestations
- Thought to follow separate stages, though there is overlap:
- Prodromal phase, with atopy, allergic rhinitis, asthma, chronic rhinosinusitis
- Eosinophilic phase, with peripheral eosinophilia (greater than 0.5), with a mean eosinophil count of 7.5
- Vasculitic phase, with the development of end-organ damage from vasculitis, often with fevers, malaise, and weight loss
- Asthma (90%), which precedes vasculitis by around 10 years
- Allergic rhinitis, recurrent sinusitis, nasal polyposis, nasal obstruction, characterized by nasal discharge (90%), congestion (85%), facial pain/pressure (85%)
- Skin involvement during the vasculitic phase, with tender subcutaneous nodules particularly on the elbows, hands, and legs
- Peripheral neuropathy (mononeuritis multiplex) (75%)
- Kidney injury (25%)
- Eosinophilic gastritis or enteritis, with abdominal pain (605), diarrhea (30%), GI bleed (20%)
- Myalgias and arthralgias and even arthritis (40-50%)
- Lymphadenopathy (30-40%)
