Clinical, Biomarker, and Radiological Progression from Asthma to Systemic Eosinophilic Granulomatosis with Polyangiitis: A Retrospective Cohort Study

作者：Chenyang Lu, Changxing Ou, Yu Deng, Na Li, Yue Ma, JinXi Luo, Jiaxuan Zhou, Kian Fan Chung, Zhenan Deng, Qingling Zhang · 发表于：Journal of Asthma and Allergy · 年份：2025 · DOI：10.2147/jaa.s542255 · 被引用次数：1 · 研究领域：Vasculitis and related conditions、Eosinophilic Disorders and Syndromes、Asthma and respiratory diseases

Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multi-organ autoimmune disease characterized by eosinophilic infiltration of peripheral blood and tissues, and necrotizing granulomatous inflammation of small and medium-sized blood vessels. In the prodromal stage of EGPA, patients may present with features of refractory asthma, with the involvement of other organs occurring later when the diagnosis of EGPA is made. The difficulty of early diagnosis makes treatment difficult. Methods: We retrospectively describe patients (N=13) who attended the asthma clinic at the First Affiliated Hospital of Guangzhou Medical University between 2008 and 2024. The disease course was categorized into three stages: asthma, lung-limited or lung-dominant EGPA (L-EGPA), and systemic EGPA (S-EGPA). Patients with severe eosinophilic asthma served as controls. We evaluated baseline demographic, as well as organ involvement, complication, laboratory findings, lung function, high-resolution computed tomography (HRCT), and treatment across different disease stages. A case-crossover design and Bayesian conditional logistic regression were employed to evaluate the impact of medication use on disease progression. Results: We identified a group of EGPA patients who exhibited consistent disease progression to transit from asthma to L-EGPA, and eventually to S-EGPA. These stages exhibit distinct clinical and imaging features, with significantly elevated eosinophilic inflammatory marke...