Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome,is a rare systemic vasculitis affecting small- and medium-sized vessels. It is characterized by late-onset asthma, peripheral eosinophilia and multiorgan involvement, which may include respiratory, cutaneous, renal, neurological and hematological manifestations. Diagnosis is challenging due to clinical variability and overlapping manifestations with other inflammatory diseases.We present the case of a 58-year-old woman with a history of hypertension and Class III obesity,who was admitted to the emergency department with severe respiratory failure and a six-monthhistory of asthma. During her hospitalization, she developed marked hypereosinophilia, painlesscutaneous lesions compatible with vasculitis, acute renal impairment and thrombocytopeniaassociated with a positive Coombs test. Despite negat...