What is the role of biopsy in the workup of 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

If local organ involvement exists, obtaining a biopsy of that organ is most helpful in confirming the diagnosis. Biopsies of the following may be considered:

  • Skin
  • Lung - Open or video-assisted thoracoscopic biopsy is preferred over transbronchial
  • Renal
  • Nerve
  • Muscle - Muscle biopsy has a sensitivity of about 67% in detecting systemic vasculitis [35]

If no localizing finding exists, obtaining nerve or muscle biopsy may be considered. Sural nerve biopsy is the most feasible procedure. In the case of renal involvement, kidney biopsy results may show focal or crescentic glomerulonephritis; however, this pathological change is only consistent with, but not diagnostic of, EGPA.


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