Newly diagnosed Churga-Strauss syndrome in a female patient with suspect acute coronary syndrome

Česká verzia

Authors: R. Husár; J. Václavík; J. Lukl
Authors place of work: I. interní klinika Lékařské fakulty UP a FN Olomouc, přednosta prof. MUDr. Jan Lukl, CSc.
Published in the journal: Vnitř Lék 2008; 54(11): 1102-1105
Category: Case Report

Summary

We present a case of 60 years old patient with the history of repeated sinusitis and bronchial asthma, who developed Churg‑Strauss syndrome (CSS) with mononeuritis multiplex, skin laesions on the head and acute perimyocarditis, which led to suspicion on myocardial infarction. Diagnosis of CSS was based on clinical manifestations, blood hypereosinophilia and histological examination of nasal mucous membrane biopsy. Subsequent immunosuppressive therapy led to regression of symptoms and improvement of temporarily decreased left ventricular function.

Key words:
Churg‑Strauss sydrome – myocarditis – hypereosinophilia – asthma

Zdroje

1. Churg J, Strauss L. Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am J Pathol 1951; 27: 277–301.

2. Della Rossa A, Baldini C, Avoni A et al. Churg‑Strauss syndrome: clinical and serological featurs of 19 patients a single Italian centre. Rheumatology 2002; 41: 1286–1294.

3. Goldberg L, Mekel J, Chita J. Acute myocarditis in patient with eosinophilia and pulmonary infiltrates. Cardiovas J South Arf 2002; 13: 29–34.

4. Hellmich B, Ehlers S, Csernok E et al.Update on the pathogenesis of Churg‑Strauss syndrome. Clin Exp Rheumatol 2003; 21 (Supl 32): S69–S77.

5. Vaglio A, Martorana D, Maggiore U et al. HLA‑DRB4 as genetic risk factor for Churg‑Strauss Syndrome. Arthritis Rheum 2007; 56: 3159–3166.

6. Uren NG, Hammond PJ. Myopeircarditis in Churg‑Strauss Syndrome. Texas Heart Instituce Journal 1991; 15: 127–131.

7. Melvin D, Cheitin MS, Malcolm BM. Klinická kardiologie. 6. vyd. Praha: Nakladatelství H&H Vyšehradská 2005: 782–784.

8. Guillevin L, Cohen P, Gayraud M et al. Churg‑Strauss syndrome, clinical study and long‑term follow‑up of 96 patients. Medicine (Baltimore) 1999; 78: 26–37.

9. Masi AT, Hunder, GG, Liem JT et al. The American College of Rheumatology 1990 criteria for the classification of Churg‑Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 1990; 33: 1094–1100.

10. Sable-Fourtassou R, Cohen P, Mahr A et al. Antineutrophil cytoplasmis antibodies and the Churg‑Strauss syndrome. Ann Intern Med 2005; 143: 632–635.

11. Baunwald’s Heart Disease. 7th ed. Elsevier Saunders 2005: 2106–2107.

12. Liou HH, Liu HM, Chiang IP et al. Case report: Churg‑Strauss syndrome presented as multiple intracerebral hemorrhage. Lupus 1997; 6: 279–282.