PT  - JOURNAL ARTICLE
AU  - Jung Yoon  Pyo
AU  - Sung Soo  Ahn
AU  - Jason Jungsik  Song
AU  - Yong-Beom Park
AU  - Sang-Won Lee
TI  - The reclassification of patients with previously diagnosed eosinophilic granulomatosis with polyangiitis based on the 2022 ACR/EULAR criteria for ANCA-associated vasculitis
AID  - 10.3899/jrheum.220560
DP  - 2022 Sep 15
TA  - The Journal of Rheumatology
PG  - jrheum.220560
4099  - http://www.jrheum.org/content/early/2022/09/11/jrheum.220560.short
4100  - http://www.jrheum.org/content/early/2022/09/11/jrheum.220560.full
AB  - Objective The American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology (EULAR) have proposed the 2022 classification criteria for eosinophilic granulomatosis with polyangiitis (EGPA). This study applied the 2022 ACR/EULAR criteria to Korean patients with previously diagnosed EGPA to investigate the concordance rate between the 2022 ACR/EULAR criteria and the old criteria for EGPA. Methods Fifty-one patients with EGPA, who fulfilled the 1990 ACR criteria, the 2007 EMA algorithm, and the 2012 CHCC definitions were reclassified based on the 2022 ACR/EULAR criteria. Results Of the 51 patients, 44 patients (86.3%) were reclassified as EGPA according to the 2022 ACR/EULAR criteria. Among the 7 patients who failed to meet the 2022 ACR/EULAR criteria, 3 patients were reclassified as having MPA, 1 as having GPA based on the 2022 ACR/EULAR criteria, and 3 as unclassifiable vasculitis. Moreover, 6 patients who met the 2022 ACR/EULAR criteria for EGPA simultaneously met the criteria for microscopic polyangiitis (MPA), and 1 patient met the criteria for GPA based on the 2022 ACR/EULAR criteria for MPA and GPA. Conclusion The concordance rate between the 2022 ACR/EULAR criteria for EGPA and the old criteria was 86.3%. The most important factor in the failure to reclassify patients as EGPA was the exclusion of non-fixed pulmonary infiltrates in the 1990 ACR criteria for EGPA. We carefully suggest that non-fixed pulmonary infiltrates should be reconsidered in cases reclassified as unclassifiable vasculitis and additional classification strategies are needed for patients who simultaneously satisfy both AAV subtypes.