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Cognitive impairment in patients with eosinophilic granulomatosis with polyangiitis (EGPA): Service evaluation in a regional severe asthma centre in North-west England

Sarah Diver, Binita Kane, Dorothy Ryan, Leanne Jo Holmes, Steve Fowler, Robert Niven
European Respiratory Journal 2016 48: PA5017; DOI: 10.1183/13993003.congress-2016.PA5017
Sarah Diver
1Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, United Kingdom
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Binita Kane
1Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, United Kingdom
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Dorothy Ryan
1Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, United Kingdom
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Leanne Jo Holmes
1Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, United Kingdom
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Steve Fowler
1Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, United Kingdom
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Robert Niven
1Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, United Kingdom
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Abstract

Background: Cognitive decline in EGPA is rare. 30% of patients with small vessel vasculitis may have subclinical neuropsychological impairment1. Data is limited regarding EGPA alone.

Aim: To evaluate prevalence of cognitive impairment in patients with EGPA managed at a regional severe asthma centre in South Manchester, England.

Methods: Cases identified where diagnosis of EGPA made by a specialist in eosinophilic vasculitis. Clinical consultations reviewed for subjective evidence of disease-related cognitive decline.

Results: N = 16, 11 male, mean age 53. 25% had antibodies to myeloperoxidase (MPO). Cognitive impairment was present in 37.5% (6). Memory loss was described in all 6, poor concentration in 2, slowed speech in 1. 4 of 6 had magnetic resonance (MR) cerebral angiogram and 2 standard MR brain. Frontal white matter hyperintensities were seen on standard MR in 2. All other brain imaging was normal. 5 of 6 were reviewed by a neurologist.

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Discussion: Evaluation of our service indicates that disease-related cognitive impairment is more prevalent than literature suggests. Further objective evidence is required. This reinforces the importance of a multidisciplinary approach in EGPA.

Reference:Frequency and patterns of subclinical cognitive impairment in patients with ANCA-associated small vessel vasculitides. Mattioli et al. J Neurol Sci. 2002.

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Cognitive impairment in patients with eosinophilic granulomatosis with polyangiitis (EGPA): Service evaluation in a regional severe asthma centre in North-west England
Sarah Diver, Binita Kane, Dorothy Ryan, Leanne Jo Holmes, Steve Fowler, Robert Niven
European Respiratory Journal Sep 2016, 48 (suppl 60) PA5017; DOI: 10.1183/13993003.congress-2016.PA5017

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Cognitive impairment in patients with eosinophilic granulomatosis with polyangiitis (EGPA): Service evaluation in a regional severe asthma centre in North-west England
Sarah Diver, Binita Kane, Dorothy Ryan, Leanne Jo Holmes, Steve Fowler, Robert Niven
European Respiratory Journal Sep 2016, 48 (suppl 60) PA5017; DOI: 10.1183/13993003.congress-2016.PA5017
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