"All that wheezes is not asthma" It is a small vessel vasculitis that is anca mediated. It has 3 phases: 1)Allergic phase 2) eosinophilic phase 3) vasculitis phase Treatment involves around immunosuppression with high dose iv steroids for 3 days plus oral steroids tapered over 4-6 weeks plus cyclophosamide for 6 months. Intolerance to cyclophosamide we can directly use Rituximab.