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

Updated: Dec 24, 2018
  • Author: Spencer T Lowe, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

In the limited number of reported cases of EGPA studied with CT scanning, findings included peripheral areas of parenchymal consolidation with ground-glass attenuation similar to that of chronic eosinophilic pneumonia. [28, 29] Much less commonly, parenchymal nodules (from 5 mm to 3.5 cm), with cavitation or air bronchograms, can be observed. Bronchial dilatation and bronchial wall thickening may also be visible.

High-resolution CT scanning of chest produces findings that include significant enlargement of peripheral pulmonary arteries with stellate and irregular configuration—a vasculitis pattern.

Diffuse subendocardial fibrosis or past myocarditis was seen on cardiovascular magnetic resonance imaging in both ANCA-positive and ANCA-negative patients with EGPA in a study that included 28 EGPA patients, but the incidence and amount of fibrosis was significantly higher in ANCA-negative patients. Acute cardiac lesions were observed in all ANCA-negative patients with active disease and acute cardiac symptoms but in only one asymptomatic ANCA-positive patient with active disease. During 2 years of follow-up, one third of the EGPA patients with diffuse subendocardial fibrosis developed deterioration in left ventricular dysfunction. [30]


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