Abstract
Neurological manifestation of Churg-Strauss syndrome (CSS) is common and usually consists of peripheral neuropathy due to small-vessel vasculitis, while cerebral manifestation is less frequent. We report the case of a 77-year-old woman with multiple cerebral infarctions and hypereosinophilia. The presence of hypereosinophilia, asthma, sinusitis and vasculitis led to the diagnosis of CSS. As cerebral infarctions occurred monophasically and an elevation of heart enzymes was present, we assumed cardiac involvement and multiple cerebral infarctions due to cardiac embolism. Treatment with high-dose IV methylprednisone and cyclophosphamide pulses led to significant improvement. This case illustrates multiple cerebral infarctions in CSS. CSS should always be considered in patients with hypereosinophilia and stroke.
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References
Abu-Shakra M, Smythe H, Lewtas J, Badley E, Weber D, Keystone E (1994) Outcome of polyarteritis nodosa and Churg-Strauss syndrome: an analysis of twenty-five patients. Arthritis Rheum 37(12):1798–1803
Allenbach Y, Seror R, Pagnoux C, Teixeira L, Guilpain P, Guillevin L, French Vasculitis Study Group (2009) High frequency of venous thromboembolic events in Churg-Strauss syndrome, Wegener’s granulomatosis and microscopic polyangiitis but not polyarteritis nodosa: a systematic retrospective study on 1130 patients. Ann Rheum Dis 68(4):564–567
Bhagirath KM, Paulson K, Ahmadie R, Bhalla RS, Robinson D, Jassal DS (2009) Clinical utility of cardiac magnetic resonance imaging in Churg-Strauss syndrome: case report and review of the literature. Rheumatol Int 29(4):445–449 (Epub 2008 Sep 20)
Dinç A, Soy M, Pay S, Simsek I, Erdem H, Sobaci G (2000) A case of Churg-Strauss syndrome presenting with cortical blindness. Clin Rheumatol 19(4):318–320
Gayraud M, Guillevin L, Cohen P et al (1997) Treatment of good-prognosis polyarteritis nodosa and Churg-Strauss syndrome: comparison of steroids and oral or pulse cyclophosphamide in 25 patients. French Cooperative Study Group for Vasculitides. Br J Rheumatol 36(12):1290–1297
Kang DW, Kim DE, Yoon BW, Seo JW, Roh JK (2001) Delayed diagnosis: recurrent cerebral infarction associated with Churg-Strauss syndrome. Cerebrovasc Dis 12(3):280–281
Keogh KA, Specks U (2006) Churg-Strauss syndrome. Semin Respir Crit Care Med 27(2):148–157
Kok J, Bosseray A, Brion JP, Micoud M, Besson G (1993) Chorea in a child with Churg-Strauss syndrome. Stroke 24(8):1263–1264
Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY et al (1990) The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 33(8):1094–1100
Noth I, Strek ME, Leff AR (2003) Churg-Strauss syndrome. Lancet 361(9357):587–594
Pagnoux C, Guilpain P, Guillevin L (2007) Churg-Strauss syndrome. Curr Opin Rheumatol 19(1):25–32
Reid AJ, Harrison BD, Watts RA, Watkin SW, McCann BG, Scott DG (1998) Churg-Strauss syndrome in a district hospital. QJM 91(3):219–229
Sehgal M, Swanson JW, DeRemee RA, Colby TV (1995) Neurologic manifestations of Churg-Strauss syndrome. Mayo Clin Proc 70(4):337–341
Sonneville R, Langrange M, Guidoux C, Michel M, Khellaf M, Russel S, Hosseini H (2006) The association of cardiac involvement and ischemic stroke in Churg Strauss syndrome. Rev Neurol (Paris) 162(2):229–232
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Ghaeni, L., Siebert, E., Ostendorf, F. et al. Multiple cerebral infarctions in a patient with Churg-Strauss syndrome. J Neurol 257, 678–680 (2010). https://doi.org/10.1007/s00415-009-5439-1
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DOI: https://doi.org/10.1007/s00415-009-5439-1