Early recognition of eosinophilic granulomatosis with polyangiitis in outpatient settings: musculoskeletal and gastrointestinal clues beyond respiratory disease
4 affiliations
- 1Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
- 2Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, Teramo, Italy.
- 3Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, Giulianova, Italy.
- 4UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
Abstract
Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem immune-mediated disease characterized by adult-onset asthma, eosinophilic inflammation, and necrotizing vasculitis of small-to-medium-sized vessels. Diagnosis is frequently prompted by clinically overt neurological, cardiac, renal, cutaneous, or gastrointestinal involvement. However, potentially informative manifestations may already be recognizable earlier, particularly when asthma, chronic rhinosinusitis with nasal polyps, and blood eosinophilia coexist with otherwise nonspecific extrapulmonary findings. Most cohorts describe manifestations at diagnosis or during established disease and provide limited information on their early temporal appearance across different specialties. This gap is particularly relevant to arthralgia and myalgia, which are common but poorly characterized, and to eosinophilic gastrointestinal manifestations that may initially be classified as organ-restricted eosinophilic gastrointestinal disorders. Biopsy-proven myositis is rare but has occasionally been reported at presentation or before clinically recognizable neuropathy. This review examines early and potentially recognizable manifestations of EGPA across outpatient settings, with particular attention to musculoskeletal symptoms, objective muscle involvement, eosinophilic gastrointestinal disease, and the therapeutic implications of distinguishing organ-restricted eosinophilic disease from systemic EGPA.
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BibTeX
@article{aitella2026early,
title = {{Early recognition of eosinophilic granulomatosis with polyangiitis in outpatient settings: musculoskeletal and gastrointestinal clues beyond respiratory disease}},
author = {Ernesto Aitella and Massimo De Martinis and Lia Ginaldi},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1964154},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1964154/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Early recognition of eosinophilic granulomatosis with polyangiitis in outpatient settings: musculoskeletal and gastrointestinal clues beyond respiratory disease
AU - Ernesto Aitella
AU - Massimo De Martinis
AU - Lia Ginaldi
PY - 2026
DA - 2026/10/05
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1964154
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1964154/full
AB - Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem immune-mediated disease characterized by adult-onset asthma, eosinophilic inflammation, and necrotizing vasculitis of small-to-medium-sized vessels. Diagnosis is frequently prompted by clinically overt neurological, cardiac, renal, cutaneous, or gastrointestinal involvement. However, potentially informative manifestations may already be recognizable earlier, particularly when asthma, chronic rhinosinusitis with nasal polyps, and blood eosinophilia coexist with otherwise nonspecific extrapulmonary findings. Most cohorts describe manifestations at diagnosis or during established disease and provide limited information on their early temporal appearance across different specialties. This gap is particularly relevant to arthralgia and myalgia, which are common but poorly characterized, and to eosinophilic gastrointestinal manifestations that may initially be classified as organ-restricted eosinophilic gastrointestinal disorders. Biopsy-proven myositis is rare but has occasionally been reported at presentation or before clinically recognizable neuropathy. This review examines early and potentially recognizable manifestations of EGPA across outpatient settings, with particular attention to musculoskeletal symptoms, objective muscle involvement, eosinophilic gastrointestinal disease, and the therapeutic implications of distinguishing organ-restricted eosinophilic disease from systemic EGPA.
SN - 1664-3224
ER -