What are the chest radiography findings in EGPA (Churg-Strauss syndrome)?

Updated: Dec 02, 2020
  • Author: Spencer T Lowe, MD; Chief Editor: Herbert S Diamond, MD  more...
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Chest radiography findings are as follows [28, 29] :

  • Pulmonary opacities can be found in 26%-77% of cases of EGPA; films demonstrate no abnormalities in approximately 25% of patients [29]

  • Localized parenchymal opacities usually are bilateral, peripheral, and patchy.

  • Cavitation is rare.

  • Pulmonary infiltrates may be transient; occasionally, infiltrates are similar to those observed in patients with chronic eosinophilic pneumonia, or they may be nodular (see the image below).

    Transient pulmonary infiltrates in a patient with Transient pulmonary infiltrates in a patient with Churg-Strauss syndrome (CSS).
  • Extensive air-space opacities in the setting of a drop in hemoglobin levels suggest massive intra-alveolar hemorrhage as a result of pulmonary alveolar capillaritis; hemoptysis is present in only 45%-66% of cases.

  • Pleural effusions are observed in 5%-30% of cases and can be eosinophilic.

  • Hilar nodal enlargement has occasionally been reported.

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