The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis)

Arthritis Rheum. 1990 Aug;33(8):1094-100. doi: 10.1002/art.1780330806.


Criteria for the classification of Churg-Strauss syndrome (CSS) were developed by comparing 20 patients who had this diagnosis with 787 control patients with other forms of vasculitis. For the traditional format classification, 6 criteria were selected: asthma, eosinophilia greater than 10% on differential white blood cell count, mononeuropathy (including multiplex) or polyneuropathy, non-fixed pulmonary infiltrates on roentgenography, paranasal sinus abnormality, and biopsy containing a blood vessel with extravascular eosinophils. The presence of 4 or more of these 6 criteria yielded a sensitivity of 85% and a specificity of 99.7%. A classification tree was also constructed with 3 selected criteria: asthma, eosinophilia greater than 10% on differential white blood cell count, and history of documented allergy other than asthma or drug sensitivity. If a subject has eosinophilia and a documented history of either asthma or allergy, then that subject is classified as having CSS. For the tree classification, the sensitivity was 95% and the specificity was 99.2%. Advantages of the traditional format compared with the classification tree format, when applied to patients with systemic vasculitis, and their comparison with earlier work on CSS are discussed.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asthma / complications
  • Churg-Strauss Syndrome / classification*
  • Churg-Strauss Syndrome / complications
  • Churg-Strauss Syndrome / diagnosis
  • Decision Trees
  • Eosinophilia / complications
  • Female
  • Humans
  • Hypersensitivity / complications
  • Male
  • Middle Aged
  • Rheumatology* / methods
  • Rheumatology* / trends
  • Sensitivity and Specificity
  • Societies, Medical*
  • Vasculitis / classification