Rheumatoid factor positivity in ANCA-negative eosinophilic granulomatosis with polyangiitis: cardiac mimicry, mononeuritis multiplex, and long-term outcome in a case-based systematic review.
A 42-year-old woman with long-standing asthma and rheumatoid factor (RF) of 322 IU/mL presented with myocardial infarction-like cardiac involvement despite non-obstructive coronary arteries.
Clinical pearl
High RF positivity does not exclude EGPA. In a patient with asthma, eosinophilia, and compatible ENT, neurologic, or cardiac manifestations, consider EGPA even when ANCA is negative and RF is elevated.