A Case of Churg-Strauss Syndrome

ABSTRACT

Churg-Strauss syndrome is a rare syndrome that affects small to medium sized arteries and veins. The American College of Rheumatology has proposed six criteria for the diagnosis of Churg-Strauss syndrome. These criteria are asthma, eosinophilia 10% in peripheral blood, paranasal sinusitis, pulmonary infiltrates, histological proof of vasculitis with extravascular eosinophils, mononeuritis multiplex or polyneuropathy. If at least 4 of these 6 criteria are positive, a patient shall be said to have Churg-Strauss syndrome. We report a case of a 70-year-old woman who had presented with polyneuropathy, hemorrhagic bullae and petechiae on both the legs and the arms. Previously, she had been diagnosed with asthma. Laboratory studies revealed peripheral blood eosinophilia. Water's view showed mucoperiosteal thickening and hazziness in both of the maxillary sinus. A skin biopsy revealed perivascular leukocytoclastic infiltration with marked eosinophilic infiltration. The patient was treated with prednisolone and a skin graft. Within a few days of prednisolone treatment, the clinical presentation improved with the exception of peripheral polyneuropathy.