Browse > Article

A Case of Churg-Strauss Syndrome with Multiple Tracheobronchial Mucosal Lesions  

Boo, Sun-Jin (Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Lee, Kwangha (Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Ra, Seung Won (Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Jin, Young-Joo (Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Park, Gyung-Min (Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Hong, Sang-Bum (Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Publication Information
Tuberculosis and Respiratory Diseases / v.65, no.5, 2008 , pp. 405-409 More about this Journal
Abstract
Churg-Strauss syndrome is a rare form of systemic necrotizing vasculitis that occurs exclusively in patients with asthma, and is associated with blood and tissue eosinophilia. The classic pathology findings in the lung include a combination of eosinophilic pneumonia, granulomatous inflammation and necrotizing vasculitis. However, there are few reports of tracheobronchial mucosal lesions in Churg-Strauss syndrome. We report a case of Churg-Strauss syndrome with multiple tracheobronchial mucosal lesions in a 33-year-old man with a history of bronchial asthma and allergic rhinitis. He had been diagnosed with community acquired pneumonia at another hospital and was treated with antibiotics. However, the chest radiographic findings were aggravated and showed multifocal consolidations in the whole lung fields. He was transferred to the Asan Medical Center. Fiberoptic bronchoscopy revealed multiple nodular mucosal lesions of the trachea and bronchi. The histopathology of the mucosal lesions revealed necrotizing bronchial inflammation with eosinophilic infiltration. Video Assisted Thoracic Surgery was performed. The wedge resected lung tissue revealed chronic eosinophilic pneumonia that was consistent with Churg-Strauss syndrome. Methylprednisolone (1 mg/kg q 8 hr) was prescribed and his symptoms resolved gradually. The chest radiographic findings improved significantly, and a follow-up fiberoptic bronchoscopy performed eight days later showed that the tracheobronchial mucosal lesions had resolved. The patient was prescribed oral prednisolone for 20 months after discharge. Currently, the patient is not taking steroids and is being followed up.
Keywords
Churg-Strauss syndrome; Multiple tracheobronchial mucosal lesions; Methylprednisolone;
Citations & Related Records

Times Cited By SCOPUS : 0
연도 인용수 순위
  • Reference
1 Alvarez-Sala R, Prados C, Armada E, Del Arco A, Villamor J. Congestive cardiomyopathy and endobronchial granulomas as manifestations of Churg-Strauss syndrome. Postgrad Med J 1995;71:365-6.   DOI
2 Matsushima H, Takayanagi N, Kurashima K, Tokunaga D, Ubukata M, Kawabata Y, et al. Multiple tracheobronchial mucosal lesions in two cases of Churg-Strauss syndrome. Respirology 2006;11:109-12.   DOI   ScienceOn
3 Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP, et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 1990;33:1094-100.   DOI   ScienceOn
4 Nouraei SA, Obholzer R, Ind PW, Salama AD, Pusey CD, Porter F, et al. Results of endoscopic surgery and intralesional steroid therapy for airway compromise due to tracheobronchial Wegener's granulomatosis. Thorax 2008;63:49-52.   DOI   ScienceOn
5 Cordier JF, Valeyre D, Guillevin L, Loire R, Brechot JM. Pulmonary Wegener's granulomatosis: a clinical and imaging study of 77 cases. Chest 1990;97:906-12.   DOI   ScienceOn
6 Judson MA, Sahn SA. Endobronchial lesions in HIV-infected individuals. Chest 1994;105:1314-23.   DOI   ScienceOn
7 Daum TE, Specks U, Colby TV, Edell ES, Brutinel MW, Prakash UB, et al. Tracheobronchial involvement in Wegener's granulomatosis. Am J Respir Crit Care Med 1995;151:522-6.   DOI   ScienceOn
8 Noth I, Strek ME, Leff AR. Churg-Strauss syndrome. Lancet 2003;361:587-94.   DOI   ScienceOn
9 Churg J, Strauss L. Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am J Pathol 1951;27: 277-301.
10 Lanham JG, Elkon KB, Pusey CD, Hughes GR. Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome. Medicine (Baltimore) 1984;63:65-81.   DOI
11 Solans R, Bosch JA, Perez-Bocanegra C, Selva A, Huguet P, Alijotas J, et al. Churg-Strauss syndrome: outcome and long-term follow-up of 32 patients. Rheumatology (Oxford) 2001;40:763-71.   DOI   ScienceOn
12 Guillevin L, Cohen P, Gayraud M, Lhote F, Jarrousse B, Casassus P. Churg-Strauss syndrome: clinical study and long-term follow-up of 96 patients. Medicine (Baltimore) 1999;78:26-37.   DOI   ScienceOn
13 Yang KJ, Moon HS, Lee WK, Song JS, Ro JC, Park SH, et al. A case of allergic granulomatosis. Tuberc Respir Dis 1986;33:247-51.
14 An JY, Lee JE, Park HW, Lee JH, Yang SA, Jung SS, et al. Clinical and bronchoscopic features in endobronchial tuberculosis. Tuberc Respir Dis 2006;60:532-9.   DOI   ScienceOn