Churg-Strauss syndrome laboratory findings: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| (28 intermediate revisions by 2 users not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Churg-Strauss syndrome}} | {{Churg-Strauss syndrome}} | ||
{{CMG}} | |||
{{CMG}}; {{AE}}{{CK}} | |||
==Overview== | ==Overview== | ||
The laboratory findings in [[eosinophilic granulomatosis with polyangiitis]] include [[complete blood count]] with differential to evaluate abnormal [[eosinophilia]], serologic and immunologic tests to identify [[Anti-neutrophil cytoplasmic antibody|antineutrophil cytoplasmic antibodies]], acute phase reactants, and urinalysis to evaluate [[proteinuria]] and [[microscopic hematuria]]. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
Initial laboratory tests should include a [[complete blood count]] with differntial to evaluate abnormal [[eosinophilia]], and [[Anemia|anaemia]], immunologic tests to identify [[Anti-neutrophil cytoplasmic antibody|antineutrophil cytoplasmic antibodies]], elevated [[Immunoglobulin E|IgE]] levels, and [[rheumatoid factor]], urine analysis to evaluate [[proteinuria]], and [[microscopic hematuria]]. As well as other serologic tests to evaluate acute phase reactants and other infammatory mediators. | |||
===Blood work-up=== | |||
* [[Complete blood count|CBC]] with differential | |||
** [[Leukocytosis]] with marked [[eosinophilia]] is present(>10% eosinophils/µL)<ref name="pmid16933465">{{cite journal |vauthors=Keogh KA, Specks U |title=Churg-Strauss syndrome: update on clinical, laboratory and therapeutic aspects |journal=Sarcoidosis Vasc Diffuse Lung Dis |volume=23 |issue=1 |pages=3–12 |date=March 2006 |pmid=16933465 |doi= |url=}}</ref><ref name="pmid2202307">{{cite journal |vauthors=Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY |title=The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis) |journal=Arthritis Rheum. |volume=33 |issue=8 |pages=1094–100 |date=August 1990 |pmid=2202307 |doi= |url=}}</ref> | |||
** [[Anemia|Anaemia]] | |||
* Elevated [[Blood urea nitrogen|BUN]] | |||
* Elevated [[Creatinine|serum creatinine]] | |||
* Raised [[Erythrocyte sedimentation rate|ESR]] | |||
* Elevated [[c-reactive protein]] | |||
* Elevated [[troponin T]]<ref name="pmid23853013">{{cite journal |vauthors=McAleavey N, Millar A, Pendleton A |title=Cardiac involvement as the main presenting feature in eosinophilic granulomatosis with polyangiitis |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=July 2013 |pmid=23853013 |pmc=3736255 |doi=10.1136/bcr-2013-009394 |url=}}</ref> | |||
===Urinalysis=== | |||
* [[Proteinuria]] | |||
* [[Microscopic hematuria]] | |||
* Red cell casts | |||
* [[Albuminuria]] | |||
* Abnormal [[sedimentation]] | |||
===Immunologic tests=== | |||
* [[Anti-neutrophil cytoplasmic antibody|Antineutrophil cytoplasmic antibodies]]<ref name="pmid16142760">{{cite journal |vauthors=Sinico RA, Di Toma L, Maggiore U, Bottero P, Radice A, Tosoni C, Grasselli C, Pavone L, Gregorini G, Monti S, Frassi M, Vecchio F, Corace C, Venegoni E, Buzio C |title=Prevalence and clinical significance of antineutrophil cytoplasmic antibodies in Churg-Strauss syndrome |journal=Arthritis Rheum. |volume=52 |issue=9 |pages=2926–35 |date=September 2005 |pmid=16142760 |doi=10.1002/art.21250 |url=}}</ref><ref name="pmid12967693">{{cite journal |vauthors=Keogh KA, Specks U |title=Churg-Strauss syndrome: clinical presentation, antineutrophil cytoplasmic antibodies, and leukotriene receptor antagonists |journal=Am. J. Med. |volume=115 |issue=4 |pages=284–90 |date=September 2003 |pmid=12967693 |doi= |url=}}</ref> | |||
** P-ANCA positive in most cases | |||
* Elevated levels of [[Immunoglobulin E|IgE]]<ref name="pmid20523791">{{cite journal |vauthors=Choi JH, Ahn IS, Lee HB, Park CW, Lee CH, Ahn HK |title=A case of churg-strauss syndrome |journal=Ann Dermatol |volume=21 |issue=2 |pages=213–6 |date=May 2009 |pmid=20523791 |pmc=2861222 |doi=10.5021/ad.2009.21.2.213 |url=}}</ref> | |||
* Elevated levels of [[rheumatoid factor]] at low titer | |||
* [[Hypergammaglobulinemia]] | |||
* [[C3 (complement)|C3]], C4 levels may be normal or elevated | |||
* Increased levels of [[eosinophil cationic protein]]<ref name="pmid23428926">{{cite journal |vauthors=Hara T, Yamaguchi K, Iwase T, Kadota M, Bando M, Ogasawara K, Bando S, Ise T, Niki T, Ueda Y, Tomita N, Taketani Y, Yamada H, Soeki T, Wakatsuki T, Sata M |title=Eosinophilic myocarditis due to Churg-Strauss syndrome with markedly elevated eosinophil cationic protein |journal=Int Heart J |volume=54 |issue=1 |pages=51–3 |date=2013 |pmid=23428926 |doi= |url=}}</ref> | |||
===Other serologic tests=== | |||
* [[Toxocariasis]] | |||
* [[Human Immunodeficiency Virus (HIV)|Human immunodeficiency virus]] | |||
* [[Aspergillosis]] species | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category: Autoimmune disease]] | |||
[[Category: Pulmonology]] | |||
[[Category: Rheumatology]] | |||
Latest revision as of 17:57, 12 April 2018
|
Churg-Strauss syndrome Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Churg-Strauss syndrome laboratory findings On the Web |
|
American Roentgen Ray Society Images of Churg-Strauss syndrome laboratory findings |
|
Risk calculators and risk factors for Churg-Strauss syndrome laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
The laboratory findings in eosinophilic granulomatosis with polyangiitis include complete blood count with differential to evaluate abnormal eosinophilia, serologic and immunologic tests to identify antineutrophil cytoplasmic antibodies, acute phase reactants, and urinalysis to evaluate proteinuria and microscopic hematuria.
Laboratory Findings
Initial laboratory tests should include a complete blood count with differntial to evaluate abnormal eosinophilia, and anaemia, immunologic tests to identify antineutrophil cytoplasmic antibodies, elevated IgE levels, and rheumatoid factor, urine analysis to evaluate proteinuria, and microscopic hematuria. As well as other serologic tests to evaluate acute phase reactants and other infammatory mediators.
Blood work-up
- CBC with differential
- Leukocytosis with marked eosinophilia is present(>10% eosinophils/µL)[1][2]
- Anaemia
- Elevated BUN
- Elevated serum creatinine
- Raised ESR
- Elevated c-reactive protein
- Elevated troponin T[3]
Urinalysis
- Proteinuria
- Microscopic hematuria
- Red cell casts
- Albuminuria
- Abnormal sedimentation
Immunologic tests
- Antineutrophil cytoplasmic antibodies[4][5]
- P-ANCA positive in most cases
- Elevated levels of IgE[6]
- Elevated levels of rheumatoid factor at low titer
- Hypergammaglobulinemia
- C3, C4 levels may be normal or elevated
- Increased levels of eosinophil cationic protein[7]
Other serologic tests
References
- ↑ Keogh KA, Specks U (March 2006). "Churg-Strauss syndrome: update on clinical, laboratory and therapeutic aspects". Sarcoidosis Vasc Diffuse Lung Dis. 23 (1): 3–12. PMID 16933465.
- ↑ Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY (August 1990). "The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis)". Arthritis Rheum. 33 (8): 1094–100. PMID 2202307.
- ↑ McAleavey N, Millar A, Pendleton A (July 2013). "Cardiac involvement as the main presenting feature in eosinophilic granulomatosis with polyangiitis". BMJ Case Rep. 2013. doi:10.1136/bcr-2013-009394. PMC 3736255. PMID 23853013.
- ↑ Sinico RA, Di Toma L, Maggiore U, Bottero P, Radice A, Tosoni C, Grasselli C, Pavone L, Gregorini G, Monti S, Frassi M, Vecchio F, Corace C, Venegoni E, Buzio C (September 2005). "Prevalence and clinical significance of antineutrophil cytoplasmic antibodies in Churg-Strauss syndrome". Arthritis Rheum. 52 (9): 2926–35. doi:10.1002/art.21250. PMID 16142760.
- ↑ Keogh KA, Specks U (September 2003). "Churg-Strauss syndrome: clinical presentation, antineutrophil cytoplasmic antibodies, and leukotriene receptor antagonists". Am. J. Med. 115 (4): 284–90. PMID 12967693.
- ↑ Choi JH, Ahn IS, Lee HB, Park CW, Lee CH, Ahn HK (May 2009). "A case of churg-strauss syndrome". Ann Dermatol. 21 (2): 213–6. doi:10.5021/ad.2009.21.2.213. PMC 2861222. PMID 20523791.
- ↑ Hara T, Yamaguchi K, Iwase T, Kadota M, Bando M, Ogasawara K, Bando S, Ise T, Niki T, Ueda Y, Tomita N, Taketani Y, Yamada H, Soeki T, Wakatsuki T, Sata M (2013). "Eosinophilic myocarditis due to Churg-Strauss syndrome with markedly elevated eosinophil cationic protein". Int Heart J. 54 (1): 51–3. PMID 23428926.