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Question category: Rheumatology

A 42 year old gentleman has had chronic problems with rhinitis. He has just been recently diagnosed with asthma. He has had a few episodes of haemoptysis. He also has a purpuric rash. Bloods revealed an eosinophilia and autoantibodies revealed a positive pANCA and cANCA. CXR shows interstitial shadowing reported as pneumonitis. What is the most likely diagnosis?

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