Table 1.

Teaching points

•Eosinophilic granulomatosis with polyangiitis (EGPA) patients exhibit renal involvement in nearly a quarter of cases.

•The frequency of renal involvement and its histopathological manifestations is driven by anti-neutrophil cytoplasm antibodies (ANCA) status:

○The great majority of EGPA patients with renal involvement are ANCA positive;

○Necrotizing pauci-immune glomerulonephritis is the most common renal presentation in ANCA-positive EGPA;

○Significant eosinophilic interstitial inflammation is found in half of the cases;

○Renal involvement is infrequent in ANCA-negative EGPA, and atypical renal presentation may occur.

•The course of renal disease in EGPA may be severe and should be managed accordingly.