Abstract
Churg–Strauss syndrome (CSS) is a rare vasculitic disorder that generally occurs in patients with bronchial asthma. CSS is being increasingly recognized in asthmatic patients treated with leukotriene receptor antagonists. However, the nature of this relationship remains to be elucidated. The present report describes three asthmatic patients who developed clinical manifestations highly suggestive of CSS, although one patient lacked the presence of eosinophilia. The patient, however, exhibited biopsy-proven cutaneous necrotizing vasculitis, which improved after withdrawal of montelukast. The second patient presented with systemic constitutional signs including fever, malaise, arthralgias, clinical jaundice, peripheral blood eosinophilia, and biopsy-proven eosinophilic hepatitis. The third patient also had circulating eosinophilia, scleritis, and arthritis. All patients improved after discontinuation of the leukotriene receptor antagonist (montelukast).
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References
Noth I, Strek M, Left A (2003) Churg–Strauss syndrome. Lancet 361:587–594
Wechsler ME, Garpestad E, Flier SR et al (1998) Pulmonary infiltrates, eosinophilia, and cardiomyopathy following corticosteroid withdrawal in patients with asthma receiving zafirlukast. JAMA 279:455–457
Wechsler ME, Finn D, Gunawardena D et al (2000) Churg–Strauss syndrome in patients receiving montelukast as treatment for asthma. Chest 117:708–713
Conen D, Leuppi J, Bubendorf L et al (2004) Montelukast and Churg–Strauss syndrome. Swiss Med Wkly 134:377–380
Weller PF, Plaut M, Taggart V, Trontell A (2001) The relationship of asthma therapy and Churg–Strauss syndrome: NIH workshop summary report. J Allergy Clin Immunol 108:175–183
DuMouchel W, Smith ET, Beasley R et al (2004) Association of asthma therapy and Churg–Strauss syndrome : an analysis of postmarketing surveillance data. Clin Ther 26:1092–1104
Shimbo J, Onodera O, Tanaka K, Tsuji S (2005) Churg–Strauss syndrome and the leukotriene receptor antagonist pranlukast. Clin Rheumatol 24:661–662
Keogh KA, Specks U (2006) Churg–Strauss syndrome. Semin Respir Crit Care Med 27:148–157
Otani Y, Ansai S, Shibuya H et al (2003) Churg–Strauss syndrome (CSS) manifested as necrosis of fingers and toes and liver infarction. J Dermatol 30:810–815
Androudi S, Iaccheri B, Brazitikos P, Papadaki T, Foster CS (2004) Bilateral chronic anterior uveitis and neuro-ophthalmologic manifestations in a patient with Churg–Strauss syndrome: an unusual ocular manifestation. Ocul Immunol Inflamm 12:59–63
Garcia-Marcos L, Schuster A (2001) Antileukotrienes in asthma: present situation. Expert Opin Pharmacother 2:441–466
Merck (1999) Post marketing research data. Merck, Rahway, NJ
Wechsler ME, Finn D, Gunawardena D et al (2000) Churg–Strauss syndrome in patients receiving montelukast as treatment for asthma. Chest 117:1–9
Guilpain P, Viallard JF, Lagarde P et al (2002) Churg–Strauss syndrome in two patients receiving montelukast. Rheumatology 41:535–539
Hellmich B, Csernok E, Gross W (2005) Proinflammatory cytokines and autoimmunity in Churg–Strauss syndrome. Ann N Y Acad Sci 1051:121–131
Hauser T, Mahr AD, Metzler C et al (2006) Leukotriene receptor antagonists (Montelukast) and the risk of Churg–Strauss syndrome (abstract). Arthritis Rheum 54:S496
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Cuchacovich, R., Justiniano, M. & Espinoza, L.R. Churg–Strauss syndrome associated with leukotriene receptor antagonists (LTRA). Clin Rheumatol 26, 1769–1771 (2007). https://doi.org/10.1007/s10067-006-0510-0
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DOI: https://doi.org/10.1007/s10067-006-0510-0