scholarly journals Testing, testing, testing: an insidious hypereosinophilia

2013 ◽  
pp. 163-165
Author(s):  
Livia Robbiolo ◽  
Annalisa Carbone ◽  
Fabrizio Favales ◽  
Barbara Spelta ◽  
Fabrizio Colombo
Keyword(s):  
Histopathological Examination ◽  
Systemic Vasculitis ◽  
Acute Bronchitis ◽  
Emergency Laparotomy ◽  
Rare Entity ◽  
Mononeuritis Multiplex ◽  
History Of ◽  
Strauss Syndrome ◽  
Eosinophil Granulocytes ◽  
Churg Strauss

Aim of the study: This case focuses on the difficulty in recognizing this rare entity characterized by systemic vasculitis in patients with history of asthma. Clinical case: We report a case of a 46-year-old man with history of allergic rhinitis and referred episodes of shortness of breath recognizing as acute bronchitis who presented with fever, skin eruption, peripheral eosonophilia, muscle weakness, abdominal pain and progressively dyspnea. Methods: Chest radiograph and computed tomography on admission showed consolidation in both lung fields and pericardial effusion. P-serum ANCA were positive. Neurological examination revealed mononeuritis multiplex. A skin biopsy was performed with presence of eosinophil granulocytes. The condition did not respond to antibiotics. He was supposed to have vasculitis and steroid treatment was started at a dose of 1 mg/kg; eosinophilia decreased but there was no clinical improvement. Abdominal pains were progressively more severe; emergency laparotomy revealed ileum infiammation, histopathological examination was consistent with Churg-Strauss syndrome.

A 55-Year-Old Female with a History of Right Foot Drop and Left Hand Weakness

2016 ◽  
Author(s):  
Jeffrey A. Cohen ◽  
Justin J. Mowchun ◽  
Victoria H. Lawson ◽  
Nathaniel M. Robbins
Keyword(s):  
Systemic Vasculitis ◽  
Immunosuppressive Treatment ◽  
Abrupt Onset ◽  
Conclusive Evidence ◽  
Foot Drop ◽  
Mononeuritis Multiplex ◽  
Vasculitic Neuropathy ◽  
Left Hand ◽  
Serologic Markers ◽  
History Of

Vasculitic neuropathy often presents as a mononeuritis multiplex pattern. Ischemic nerve injury can lead to abrupt-onset, painful, and multifocal sensorimotor neuropathy. This chapter emphasizes the diagnostic considerations of vasculitic neuropathy, which includes the significant limitations of serologic markers in non-systemic vasculitic neuropathy. Nerve and muscle biopsy are important investigations to consider to make the diagnosis. Keys to management are also reviewed. It is important to manage systemic vasculitis with a rheumatologist. Nonsystemic vasculitis has a much better prognosis; immunosuppressive treatment is less aggressive, but it is recommended to have a rheumatologist’s input. There is no conclusive evidence on how to treat nonsystemic vasculitis. Mild cases may be treated with steroids alone.

scholarly journals A Case of Montelukast-Induced Churg-Strauss Syndrome Associated with Liver Dysfunction

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Keiji Matsui ◽  
Kosuke Nishijima
Keyword(s):  
Liver Dysfunction ◽  
Carnitine Deficiency ◽  
Acid Oxidation ◽  
Fatty Change ◽  
Churg Strauss Syndrome ◽  
History Of ◽  
Strauss Syndrome ◽  
Leukotriene Receptor ◽  
The Relationship ◽  
Churg Strauss

A 64-year-old woman was admitted to hospital due to protracted diarrhea and liver dysfunction. The patient was diagnosed as Churg-Strauss syndrome (CSS) due to asthma, paranasal sinusitis, hypereosinophilia, and polyneuropathy. There was a history of taking montelukast, a leukotriene receptor antagonist (LTRA), which is thought to have some relationship with CSS. The liver biopsy specimen showed eosinophilic infiltration and centrolobular fatty change. In this paper, we review the relationship between LTRA and CSS. Several lines of evidence suggest that leukotriene plays an important role in maintaining neural tissues. We also review the potential relationship between centrolobular fatty change and pivoxil-containing antibiotics, which was prescribed for sinusitis before admission. Carnitine deficiency induced by pivoxil-containing agents may cause impaired fatty acid oxidation in mitochondria.

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.

Pulmonary vasculitis

2018 ◽  
Author(s):  
Rajini Sudhir
Keyword(s):  
Vessel Wall ◽  
Microscopic Polyangiitis ◽  
Systemic Vasculitis ◽  
Staging System ◽  
Clinical Staging ◽  
Tissue Necrosis ◽  
Pulmonary Vasculitis ◽  
Strauss Syndrome ◽  
Clinical Staging System ◽  
Churg Strauss

Pulmonary vasculitis comprises a heterogeneous group of disorders characterized by an inflammatory process damaging the vessel wall, leading to ischaemia and tissue necrosis. Wegener’s granulomatosis, Churg–Strauss syndrome, and microscopic polyangiitis are primary, small-vessel, necrotizing vasculitides linked by an overlapping clinicopathological picture and are referred to collectively as ANCA-associated systemic vasculitis. The European Vasculitis Study Group proposed a clinical staging system based on disease activity, to guide treatment.

EARLY MUSCLE AFFECTION IN CHURG–STRAUSS SYNDROME

2005 ◽  
Vol 09 (01) ◽  
pp. 53-58
Author(s):  
Josef Finsterer ◽  
Christine Haberler
Keyword(s):  
Skeletal Muscle ◽  
Muscle Involvement ◽  
Churg Strauss Syndrome ◽  
Blood Sedimentation ◽  
Epitheloid Cells ◽  
Blood Sedimentation Rate ◽  
Dominant Feature ◽  
History Of ◽  
Strauss Syndrome ◽  
Churg Strauss

Purpose: Skeletal muscle affection already in the eosinophilic stage of Churg–Strauss syndrome (CSS) is unusual. Case report: In a 36-year-old woman with a history of recurrent bronchial infections since childhood, recurrent poly-sinusitis and nasal polyps, and bronchial asthma, easy fatigability, weakness of the lower arms and lower legs, generalized myalgias with predominance of the lower arms, recurrent vertigo and falls developed. There was recurrently elevated creatine-kinase, glutamate-oxalate-transaminase, aldolase, lactate-dehydrogenase, eosinophilic granulocyte-count, thrombocyte-count, cholesterol, and blood sedimentation rate. Histologically polyps showed diffuse infiltrations of eosinophils exclusively. Muscle biopsy revealed grouped atrophic fibers, necrotic fibers, rarely regenerating fibers, epitheloid cells and rarely perimysial eosinophilic granulozytes. According to established criteria, CSS was diagnosed. Conclusions: This case shows that affection of the skeletal muscle in CSS, may manifest as easy fatigability, myalgias, and recurrently elevated CK, and that skeletal muscle involvement may be a dominant feature not only of the vasculitic but also of the eosinophilic stage of CSS.

Anca in Dialysis Patients: A Role for Bioincompatibility?

2000 ◽  
Vol 23 (2) ◽  
pp. 97-103 ◽  
Author(s):  
B. Andreini ◽  
V. Panichi ◽  
C. Cirami ◽  
M. Migliori ◽  
S. DE Pietro ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Microscopic Polyangiitis ◽  
Systemic Vasculitis ◽  
Renal Diseases ◽  
Dialysis Membrane ◽  
Dialysis Patients ◽  
Wegener Granulomatosis ◽  
Pathological Conditions ◽  
Strauss Syndrome ◽  
Churg Strauss

Background Anti-neutrophil cytoplasmic autoantibodies (ANCA) have been described in patients suffering from systemic vasculitis such as Wegener granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome and other pathological conditions. In this paper we report a greater incidence of ANCA in hemodialysis patients as compared to peritoneal dialysis patients, predialytic uremic patients and non-renal patients; a possible role for dialysis bioincompatibility in ANCA generation was also investigated. Methods A total of 335 uremics in substitutive treatment (176 in hemodialytic treatment and 159 in peritoneal dialysis) were examined for ANCA positivity. A total of 189 patients with advanced renal failure in conservative treatment and 100 healthy subjects were used as control. The dialysis techniques were standard hemodialysis (n = 119), low volume hemodiafiltration (n = 26) and hemofiltration (n = 31). ANCA positivity was examined by immunofluorescence (IF): diffuse finely granular staining was considered as classical positive reaction (C-ANCA) and P-ANCA was diagnosed if a perinuclear staining was observed. EIA for proteinase-3 (anti PR-3) and myeloperoxidase-antibodies (anti-MPO) were also performed. Results In non-renal patients and in patients with pre-dialytic renal insufficiency none were found ANCA positive. In peritoneal dialysis patients all but one were ANCA negative with IF, with all EIA test resulting negative. In hemodialytic patients, a positive IF test was found in 26 (14.7%) for P-ANCA and in 5 (2.8%) for C-ANCA; using the EIA test 23 (13%) patients were positive for MPO and 12 (6.8%) for PR-3. Conclusions No correlation with age, primary renal diseases, dialytic age, dialysis membrane materials was found; regarding the different extracorporeal dialytic techniques a higher incidence (p < 0.02) was detected in patients undergoing HDF. Backfiltration of contaminated dialysate may induce ANCA via an increased cytokine generation. (Int J Artif Organs 2000; 23: 97–103)

Unusual presentation of temporal bone involvement in Churg–Strauss syndrome

2007 ◽  
Vol 122 (4) ◽  
pp. 425-427 ◽  
Author(s):  
M Martinez Del Pero ◽  
D Moffat ◽  
H Sudhoff
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Otitis Media ◽  
Sudden Onset ◽  
Sensorineural Hearing ◽  
Churg Strauss Syndrome ◽  
First Case ◽  
History Of ◽  
Strauss Syndrome ◽  
Churg Strauss

AbstractObjective:To present a case of a 60-year-old male with a history of sudden onset sensorineural hearing loss due to Churg–Strauss syndrome.Case report:The patient had a 20-year history of asthma and recurrent right otitis media and a nasal polypectomy four years prior to presenting with ear symptoms. Ear, nose and throat involvement is common in Churg–Strauss syndrome, usually manifesting as allergic rhinitis and chronic rhinosinusitis with or without polyps.Conclusions:Otolaryngologists play an important role in making an early diagnosis of this disease. To our knowledge this is the first case of Churg–Strauss syndrome primarily presenting with otological pathology: left sensorineural hearing loss and right otitis media.

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

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