Rheumatology Renal Medicine A

ACR/EULAR 2022 GPA Classification Criteria

2022 ACR/EULAR classification criteria for granulomatosis with polyangiitis (GPA): 10 weighted items (−5 to 17); a score of 5 or more classifies GPA. Apply only when small- or medium-vessel vasculitis has been diagnosed and mimics of vasculitis have been excluded.

Nasal involvement: bloody discharge, ulcers, crusting, congestion or blockage, or septal defect / perforation*

Cartilaginous involvement: ear or nose cartilage inflammation, hoarse voice or stridor, endobronchial involvement, or saddle-nose deformity*

Conductive or sensorineural hearing loss*

c-ANCA or anti-PR3 (proteinase 3) antibody positive*

Pulmonary nodules, mass, or cavitation on chest imaging*

Granuloma, extravascular granulomatous inflammation, or giant cells on biopsy*

Inflammation, consolidation or effusion of the nasal / paranasal sinuses, or mastoiditis, on imaging*

Pauci-immune glomerulonephritis on biopsy*

p-ANCA or anti-MPO (myeloperoxidase) antibody positive*

Blood eosinophil count ≥ 1 ×10⁹/L*

Score interpretation

GPA Not Classified -5–4

Score < 5: does not meet the 2022 GPA classification criteria

→ Consider MPA (MPO-ANCA), eosinophilic GPA (eGPA/Churg-Strauss), or other vasculitis

GPA (Wegener's) Classified 5–17

Score ≥ 5: meets the 2022 ACR/EULAR classification criteria for GPA

→ Urgent rheumatology/nephrology referral; ANCA titres; renal function; chest CT; consider rituximab or cyclophosphamide + high-dose steroids

Interpretation bands for the ANCA Vasculitis. Apply clinical judgement and local guidance.

References

Robson JC, et al. 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology Classification Criteria for Granulomatosis with Polyangiitis. Arthritis Rheumatol. 2022;74(3):393-399.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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