Which disease is a well-known small-vessel vasculitis frequently associated with asthma and eosinophilia?

• A. Wegener granulomatosis
• B. Churg-Strauss Syndrome
• C. Microscopic polyangiitis
• D. Kawasaki disease

Answer: (B)

Recognizing a small-vessel vasculitis that occurs with asthma and high eosinophil counts points to eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome). This disease shows eosinophil-rich granulomatous inflammation of small vessels and systemic involvement, with a typical history of asthma, allergic features, and marked eosinophilia. Neuropathy, sinusitis, skin lesions, and pulmonary infiltrates are common, and some patients have detectable p-ANCA/MPO-ANCA.

Other vasculitides differ in key ways: granulomatosis with polyangiitis (Wegener) often has c-ANCA and prominent upper airway disease with kidney involvement but not the classic asthma-eosinophilia pattern; microscopic polyangiitis usually lacks granulomatous inflammation and presents with pauci-immune glomerulonephritis and pulmonary issues without the asthma/eosinophilia link; Kawasaki disease is a pediatric mucocutaneous syndrome, not the asthma-associated eosinophilic vasculitis described here.