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Churg-Strauss Syndrome: Development of Cardiomyopathy During Corticosteroid Treatment

Churg-Strauss Syndrome: Development of Cardiomyopathy During Corticosteroid Treatment Abstract • A patient with Churg-Strauss syndrome had pulmonary lesions, vasculitis, gastrointestinal tract involvement, and leukocytosis with hypereosinophilia. A wedge section from the lung showed necrotizing granulomata filled with necrotic eosinophils and fibrinoid, and rimmed by giant cells and eosinophils. Arteries and veins of all sizes were affected with perivascular eosinophilicrich, palisaded, giant cell granulomata with evidence of partial or complete occlusion. The patient was treated with prednisone, with excellent resolution of his symptoms. Recurrent episodes of pneumonia and wheezing responded to increased levels of prednisone plus bronchodilators and antibiotics. Cardiomyopathy developed after two years while taking prednisone. His condition has been managed with digoxin, diuretics, and increased amounts of prednisone. Although our patient has shown clinical improvement in his cardiac status, objective studies show minimal resolution. (Am J Dis Child 1982;136:339-344) References 1. Churg J, Strauss L: Allergic granulomatosis, allergic anginitis and periarteritis nodosa . Am J Pathol 1951;27:277-301. 2. Abul-Haj SK, Flanagan P: Asthma associated with disseminated necrotizing granulomatous vasculitis, the Churg-Strauss syndrome: Report of a case . Med Ann DC 1961;30:670-676. 3. Sokolov RA, Rachmaninoff N, Kaine HD: Allergic granulomatosis . Am J Med 1962;32:131-141.Crossref 4. Varriale P, Minogue WF, Alfenito JC: Allergic granulomatosis: Case report and review of the literature . Arch Intern Med 1964;113:235-240.Crossref 5. Diebold J, Antebi L, Kahlifat RS, et al: Angéite allergique granulomateuse avec manifestations pulmonaires et cardiaques prédominantes . Press Med 1969;77:1211-1212. 6. Chumbley LC, Harrison EG Jr, DeRemee RA: Allegic granulomatosis and angitis (Churg-Strauss syndrome): Report and analysis of 30 cases . Mayo Clin Proc 1977;52:477-484. 7. Cooper BJ, Bacal E, Patterson R: Allergic angitis and granulomatosis: Prolonged remission induced by combined prednisone-azathioprine therapy . Arch Intern Med 1978;138:367-371.Crossref 8. Fauci AS, Wolff SM: Wegener's granulomatosis: Studies in 18 patients and a review of the literature . Medicine 1973;52:535-561.Crossref 9. Kelalis PP, Harrison EG Jr, Utz DC: Allergic granulomas of the prostate: Treatment with steroids . J Urol 1966;96:573-577. 10. Frohnert PP, Sheps SG: Long-term follow-up study of periarteritis nodosa . Am J Med 1967;43:8-14.Crossref 11. Liebow AA, Carrington CB: The eosinophilic pneumonias . Medicine 1969;48:251-285.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Churg-Strauss Syndrome: Development of Cardiomyopathy During Corticosteroid Treatment

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1982.03970400057015
Publisher site
See Article on Publisher Site

Abstract

Abstract • A patient with Churg-Strauss syndrome had pulmonary lesions, vasculitis, gastrointestinal tract involvement, and leukocytosis with hypereosinophilia. A wedge section from the lung showed necrotizing granulomata filled with necrotic eosinophils and fibrinoid, and rimmed by giant cells and eosinophils. Arteries and veins of all sizes were affected with perivascular eosinophilicrich, palisaded, giant cell granulomata with evidence of partial or complete occlusion. The patient was treated with prednisone, with excellent resolution of his symptoms. Recurrent episodes of pneumonia and wheezing responded to increased levels of prednisone plus bronchodilators and antibiotics. Cardiomyopathy developed after two years while taking prednisone. His condition has been managed with digoxin, diuretics, and increased amounts of prednisone. Although our patient has shown clinical improvement in his cardiac status, objective studies show minimal resolution. (Am J Dis Child 1982;136:339-344) References 1. Churg J, Strauss L: Allergic granulomatosis, allergic anginitis and periarteritis nodosa . Am J Pathol 1951;27:277-301. 2. Abul-Haj SK, Flanagan P: Asthma associated with disseminated necrotizing granulomatous vasculitis, the Churg-Strauss syndrome: Report of a case . Med Ann DC 1961;30:670-676. 3. Sokolov RA, Rachmaninoff N, Kaine HD: Allergic granulomatosis . Am J Med 1962;32:131-141.Crossref 4. Varriale P, Minogue WF, Alfenito JC: Allergic granulomatosis: Case report and review of the literature . Arch Intern Med 1964;113:235-240.Crossref 5. Diebold J, Antebi L, Kahlifat RS, et al: Angéite allergique granulomateuse avec manifestations pulmonaires et cardiaques prédominantes . Press Med 1969;77:1211-1212. 6. Chumbley LC, Harrison EG Jr, DeRemee RA: Allegic granulomatosis and angitis (Churg-Strauss syndrome): Report and analysis of 30 cases . Mayo Clin Proc 1977;52:477-484. 7. Cooper BJ, Bacal E, Patterson R: Allergic angitis and granulomatosis: Prolonged remission induced by combined prednisone-azathioprine therapy . Arch Intern Med 1978;138:367-371.Crossref 8. Fauci AS, Wolff SM: Wegener's granulomatosis: Studies in 18 patients and a review of the literature . Medicine 1973;52:535-561.Crossref 9. Kelalis PP, Harrison EG Jr, Utz DC: Allergic granulomas of the prostate: Treatment with steroids . J Urol 1966;96:573-577. 10. Frohnert PP, Sheps SG: Long-term follow-up study of periarteritis nodosa . Am J Med 1967;43:8-14.Crossref 11. Liebow AA, Carrington CB: The eosinophilic pneumonias . Medicine 1969;48:251-285.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Apr 1, 1982

References

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