scholarly journals Wheezing Beyond Bronchial Asthma

2013 ◽  
Vol 34 (2) ◽  
pp. 48-52
Author(s):  
P Pant ◽  
S Sharma ◽  
R Shrestha ◽  
N Bom ◽  
S Das ◽  
...  
Keyword(s):  
Joint Pain ◽  
Late Onset ◽  
Systemic Vasculitis ◽  
Clinical Manifestations ◽  
Institute Of Medicine ◽  
Upper Airways ◽  
Churg Strauss Syndrome ◽  
Progressive Dyspnea ◽  
Strauss Syndrome ◽  
Churg Strauss

Churg-Strauss syndrome (CSS) is an eosinophil-associated, small vessel granulomatous vaculitis, characterized by late onset asthma, upper airways disease, eosinophilia, and clinical manifestations of systemic vasculitis. [1,11-13] Diagnosis is mainly clinical with findings of asthma, eosinophilia, rhino sinusitis and signs of vasculitis in major organs. So far to the best of our knowledge reporting of CSS has not been done in Nepal. We here present a case of Churg- Strauss syndrome, a Anti-Neutrophil Cytoplasmic Antibody(ANCA) Associated Vasculities more specifically perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) directed against myeloperoxidase (MPO) in a 25years female patient who was initially evaluated for progressive dyspnea, wheeze, cough, joint pain and fever. Regarding the inference drawn from our case report we suggest that patient presenting with the clinical features of asthma needs further evaluation to unmask previously unrecognized underlying Churg-stauss syndrome. DOI: http://dx.doi.org/10.3126/joim.v34i2.9055 Journal of Institute of Medicine August, 2012; 34:2 48-52

scholarly journals A case of repetitive myocardial infarction with unobstructed coronaries due to Churg–Strauss syndrome

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Ying X Gue ◽  
Sanjay Prasad ◽  
David Isenberg ◽  
Diana A Gorog
Keyword(s):  
Myocardial Infarction ◽  
Coronary Disease ◽  
Late Onset ◽  
Coronary Artery Spasm ◽  
Ecg Changes ◽  
Churg Strauss Syndrome ◽  
Coronary Syndrome ◽  
Strauss Syndrome ◽  
Ct Coronary Angiogram ◽  
Churg Strauss

Abstract Background Myocardial infarction is most commonly caused by thrombosis occurring on a background of coronary atherosclerosis, resulting in reduced coronary flow. Less often, myocardial infarction can occur in the absence of coronary disease. The pathomechanism of myocardial infarction in such patients is heterogeneous and more challenging to diagnose and treat. European Society of Cardiology published a position paper on myocardial infarction in patients with non-obstructive coronary disease, with definitions and recommendations for investigations, in what has hitherto been an under-recognized and under-investigated Cinderella-like condition. However, the importance of obtaining a diagnosis is all the more important, since one treatment approach with revascularization and antithrombotic treatment does not ‘fit all’. Case summary A 70-year-old male patient presented with chest pain at rest, associated with rise in troponin and without ECG changes. A diagnosis of non-ST elevation myocardial infarction was made. Coronary angiography showed a smooth stenosis which resolved with administration of intracoronary nitrate. A diagnosis of coronary artery spasm was made, and treatment initiated. After 18 months, the patient had recurrent chest pains at rest, unresponsive to glyceryl trinitrate (GTN). Cardiac magnetic resonance revealed extension of subendocardial infarction, without inducible ischaemia. CT coronary angiogram (CTCA) showed non-obstructive coronaries. Blood tests showed significant eosinophilia, raised troponin, and C-reactive protein (CRP) that fluctuated without correlation with symptoms or any ECG changes. A diagnosis of Churg–Strauss syndrome was made, and immunosuppression commenced. Discussion Churg–Strauss syndrome is an autoimmune vasculitis in patients with history of atopy or late-onset asthma which when involving coronary arteries can lead to myocardial injury mimicking acute coronary syndrome (ACS). Identification is important to allow initiation of immunosuppression which can prevent development or progression.

Clinical Manifestations and Treatment of Churg-Strauss Syndrome

2010 ◽  
Vol 36 (3) ◽  
pp. 527-543 ◽  
Author(s):  
Chiara Baldini ◽  
Rosaria Talarico ◽  
Alessandra Della Rossa ◽  
Stefano Bombardieri
Keyword(s):  
Clinical Manifestations ◽  
Churg Strauss Syndrome ◽  
Strauss Syndrome ◽  
Churg Strauss

scholarly journals Pleural Effusion in Churg-Strauss Syndrome Detected and Successfully Treated at a Tertiary Care Institute: Case Report

2021 ◽  
Vol 6 (3) ◽  
pp. 63-65
Author(s):  
Uday Mahajan ◽  
Deepika Kapil
Keyword(s):  
Pleural Effusion ◽  
Systemic Vasculitis ◽  
Tertiary Care ◽  
Oral Prednisolone ◽  
Churg Strauss Syndrome ◽  
X Ray ◽  
Allergic Rhinitis Patient ◽  
Chief Complaints ◽  
Strauss Syndrome ◽  
Churg Strauss

Churg-Strauss syndrome is a disorder of hypereosinophilia and systemic vasculitis in subjects with asthma and allergic rhinitis. Patient was admitted with chief complaints of cough without expectoration for a duration of three weeks without accompanying fever. X ray revealed pleural effusion ‘right side’. Exudative pleural fluid with eosinophil predominance and peripheral eosinophilia. The patient was further investigated. No history suggestive of any drug use. stool routine microscopy show no parasites. ANA investigated found to be positive in 1: 80 titre in homogenous pattern. Patient was then found to be P-ANCA positive by immunofluorescence microscopy. Patient was successfully treated with oral prednisolone 40 mg for three months and subsequently improved with disappearance of symptoms. Keywords: Churg-Strauss syndrome, Pleural effusion, hypereosinophilia.

Interleukin-25: a cytokine linking eosinophils and adaptive immunity in Churg-Strauss syndrome

Blood ◽  
2010 ◽  
Vol 116 (22) ◽  
pp. 4523-4531 ◽  
Author(s):  
Benjamin Terrier ◽  
Ivan Bièche ◽  
Thierry Maisonobe ◽  
Ingrid Laurendeau ◽  
Michèlle Rosenzwajg ◽  
...  
Keyword(s):  
T Cells ◽  
Disease Activity ◽  
Adaptive Immunity ◽  
Mononuclear Cells ◽  
Systemic Vasculitis ◽  
Critical Role ◽  
Activated T Cells ◽  
Churg Strauss Syndrome ◽  
Strauss Syndrome ◽  
Churg Strauss

Abstract Churg-Strauss syndrome (CSS) is characterized by systemic vasculitis and blood and tissue eosinophilia. Blood eosinophilia correlates with disease activity, and activated T cells from CSS patients are predominantly T helper 2 (Th2). Interleukin (IL)-25 has been shown to link innate and adaptive immunity by enhancing Th2 cytokine production. We sought to determine the involvement of IL-25 and its receptor IL-17RB in the pathogenesis of CSS. We found increased levels of IL-25 in the serum of active CSS patients (952 ± 697 vs 75 ± 49 pg/mL in inactive patients and 47 ± 6 pg/mL in healthy donors). IL-25 was correlated with disease activity and eosinophil level. Eosinophils were the main source of IL-25, whereas activated CD4+ memory T cells were the IL-17RB–expressing cells in CSS. IL-25 enhanced the production of IL-4, IL-5, and IL-13 by activated peripheral blood mononuclear cells. IL-25 and IL-17RB were observed within the vasculitic lesions of patients with CSS, and IL-17RB colocalized with T cells. Increased expression of IL-17RB, tumor necrosis factor receptor–associated factor 6, and JunB in vasculitic lesions of CSS underscored the IL-25–mediated activation, whereas up-regulation of GATA3 and IL-10 supported Th2 differentiation. Our findings suggest that eosinophils, through the production of IL-25, exert a critical role in promoting Th2 responses in target tissues of CSS.

scholarly journals DIFFICULTIES IN THE EARLY DIAGNOSIS OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS (CHURGSTRAUSS SYNDROME) IN THE CLINIC OF INTERNAL DISEASES

2018 ◽  
Vol 4 (2) ◽  
pp. 38-47
Author(s):  
D. V. Cherkashin ◽  
S. A. Turdialieva ◽  
E. A. Mozharovskaya ◽  
O. M. Kudrina ◽  
A. I. Taranov
Keyword(s):  
Early Diagnosis ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Churg Strauss Syndrome ◽  
Therapy Strategy ◽  
Wide Range ◽  
Strauss Syndrome ◽  
Eosinophilic Granulomatosis ◽  
Churg Strauss

Systemic vasculitis are characterized by heterogeneity of clinical-immunological forms and determined the need for differential diagnostic search to except a wide range of diseases, such as allergic, infectious, hematological, oncological, which often presents significant difficulties for physicians of various specialties. The article presents clinical observations demonstrating the difficulties of diagnostic search in establishing the diagnosis of systemic vasculitis associated with antineutrophil cytoplasmic antibodies, which include a rare disease — eosinophilic granulomatosis with polyangiitis (Churg–Strauss syndrome). Carefully collected anamnesis, participation of specialists of different profiles, retrospective analysis of laboratory and instrumental data allowed to verify the diagnosis, to prescribe adequate therapy. The aim of the publication is to discuss the need for early diagnosis of eosinophilic granulomatosis with polyangiitis, which can improve the effectiveness of therapy and improve the overall prognosis for this disease, taking into account modern approaches based on the main provisions of international recommendations that were prepared in 2015 with the participation of leading experts from Europe, USA and Canada and were called to become the basis for choosing a personalized patient therapy strategy.

scholarly journals A case of Churg-Strauss syndrome whose diagnosis was given without the findings of systemic vasculitis and granulomatous angiitis.

Ensho ◽  
2000 ◽  
Vol 20 (2) ◽  
pp. 167-173
Author(s):  
Hiroaki Inamura ◽  
Motohiro Kurosawa ◽  
Rieko Nakagami ◽  
Jun-ichiro Morioka ◽  
Yutaka Mizushima ◽  
...  
Keyword(s):  
Systemic Vasculitis ◽  
Granulomatous Angiitis ◽  
Churg Strauss Syndrome ◽  
Strauss Syndrome ◽  
Churg Strauss

scholarly journals An unusual cause of a recurrent painful rash

2012 ◽  
Vol 11 (2) ◽  
pp. 89-92
Author(s):  
Timothy Hoi Min Fung ◽  
◽  
Cristopher Wong ◽  
Urooj Ahmed ◽  
Samina Meo ◽  
...  
Keyword(s):  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Morbidity And Mortality ◽  
Multisystem Disease ◽  
Churg Strauss Syndrome ◽  
Strauss Syndrome ◽  
Churg Strauss

Churg-Strauss syndrome is an uncommon multisystem disease involving small and medium-sized arteries, capillaries, veins, and venules. It is characterised by the presence of asthma, hypereosinophilia, and evidence of vasculitis affecting a number of organs. It is important for acute physicians to recognise this condition as delayed diagnosis results in a higher morbidity and mortality. Here we describe a case of Churg-Strauss syndrome in a 41 year old woman presenting with a recurrent painful rash. The clinical manifestations and management of this condition are discussed.

Limited form of Churg-Strauss syndrome presenting as a mass in the neck

2002 ◽  
Vol 116 (11) ◽  
pp. 966-968 ◽  
Author(s):  
J. W. Moor ◽  
J. U-King Im ◽  
A. W. MacDonald ◽  
E. Whitehead
Keyword(s):  
Diagnostic Criteria ◽  
Systemic Vasculitis ◽  
Large Mass ◽  
Histological Diagnosis ◽  
Churg Strauss Syndrome ◽  
Granulomatous Vasculitis ◽  
Supraclavicular Fossa ◽  
Strauss Syndrome ◽  
Churg Strauss

A 53-year-old man was referred to the ENT department with a large mass in the left supraclavicular fossa. The histological diagnosis showed the mass to have arisen due to a granulomatous vasculitis consistent with Churg-Strauss syndrome (CSS). CSS usually comprises asthma, eosinophilia and systemic vasculitis although limited forms of the disease exist where one of these diagnostic criteria is missing. This is one such case as the patient was non-asthmatic.

scholarly journals An Abdominal Presentation of Churg-Strauss Syndrome

2010 ◽  
Vol 2010 ◽  
pp. 1-4
Author(s):  
J. R. E. Rees ◽  
P. Burgess
Keyword(s):  
New York ◽  
Systemic Vasculitis ◽  
Granulomatous Inflammation ◽  
Signs And Symptoms ◽  
Lower Limbs ◽  
Churg Strauss Syndrome ◽  
Allergic Granulomatous Angiitis ◽  
Strauss Syndrome ◽  
Discharge From Hospital ◽  
Churg Strauss

Churg-Strauss syndrome is a small and medium vessel vasculitis that is also known as allergic granulomatous angiitis. It most commonly presents with an asthma like symptoms. It was first described in Mount Siani Hospital, New York in 1951 by Jacob Churg and Lotte Stauss and was recognised after the study of a series of 13 patients who had asthma, eosinophilia, granulomatous inflammation necrotising systemic vasculitis and necrotising glomerulonephritis. We describe a case of Churg-Strauss syndrome presenting with abdominal pain and later during the hospital admission a mono-neuritis multiplex syndrome affecting the lower limbs. The patient presented in such an atypical fashion with abdominal signs and symptoms that they required laparotomy and the diagnosis was made after histological examination of tissue taken at the time of surgery. Treatment with immunosuppression and aggressive rehabilitation achieved a progressive recovery which continued on discharge from hospital.

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