QuestionSBA
QuestionChoice
This is incorrect. This presents as a rapidly progressive glomerulonephritis with pulmonary haemorrhage.
10027710
e
Microscopic polyangiitis
QuestionChoice
This is incorrect. Although the patient is presenting with nasal polyps this is not the underlying condition and does not account for the lower respiratory tract symptoms or blood results.
10027709
d
Nasal polyps
QuestionChoice
This is incorrect. Although the patient is presenting with an allergic clinical picture, allergic rhinitis would not have a positive ANCA and would not present with symptoms of neuropathy.
10027708
c
Allergic rhinitis
QuestionChoice
This is incorrect. GPA (Wegener's Granulomatosis) is also a small and medium vessel vasculitis. However, as well as upper and lower respiratory tract symptoms it is characterised by pauci-immune glomerulonephritis. Additional symptoms such as haematuria or frothy urine may be seen, associated with a positive p and c-ANCA.
10027707
b
Granulomatosis with polyangiitis (GPA)
QuestionChoice
This is correct. The patient is suffering from asthma with nasal polyps, symptoms of neuropathy and eosinophilia along with a positive pANCA. EGPA is an inflammatory small and medium vessel vasculitis.
10027706
a
Eosinophilic granulomatosis with polyangiitis (EGPA)
Concept
Chapter
2693
5997
Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss)
Topic
146
Rheumatology
17939
A 45 year old male patient attends the GP as they have begun to feel wheezy and short of breath with a nocturnal cough. It worsens when pollen is high. He has also been suffering from chronic sinusitis for the last 4 months. They have also experienced some pins and needles in their legs.


On examination, bilateral nasal polyps can be seen and a global wheeze can be heard on auscultation.


Blood test results are as follows:


||||
|--------------|:-------:|---------------|
|Haemoglobin|110   g/L|(M) 130 - 170, (F) 115 - 155|
|White Cell Count|7.5x10<sup>9</sup>/L|3.0 - 10.0|
|Platelets|250x10<sup>9</sup>/L|150 - 400|
|Mean Cell Volume (MCV)|85 fL|80 - 96|
|Neutrophils|5x10<sup>9</sup>/L|2.0 - 7.5|
|Lymphocytes|3.5x10<sup>9</sup>/L|1.5 - 4.0|
|Eosinophils|0.9x10<sup>9</sup>/L|0 - 0.4|
|Basophils|0.05x10<sup>9</sup>/L|0 - 0.1|


Which of the following is the most likely underlying diagnosis?
a