J Korean Soc Radiol.  2010 May;62(5):443-446. 10.3348/jksr.2010.62.5.443.

Catheter-Directed Thrombolysis of Deep Vein Thrombosis in a Patient with Churg-Strauss Syndrome: A Case Report

• Park JB
• Kim SH
• Choi JS
• Kim YH

• KMID: 2002951
• DOI: http://doi.org/10.3348/jksr.2010.62.5.443

Abstract

Vasculitis by Churg-Strauss Syndrome (CSS) is an uncommon disease characterized by the inflammation of blood vessel walls and can involve many organs. The clinical manifestations and courses of vasculitis are highly variable. Deep vein thrombosis has rarely been reported in vasculitis by CSS. We report a case of deep vein thrombosis associated with CSS that was successfully treated by catheter-directed thrombolysis.

MeSH Terms

Blood Vessels
Churg-Strauss Syndrome
Glycosaminoglycans
Humans
Inflammation
Vasculitis
Venous Thrombosis
Glycosaminoglycans

Figure

• 

  Fig. 1 A 51-year-old woman with deep vein thrombosis associated with hypereosinophilic vasculitis. A. Abdominal CT scan shows a low enhancing mass (arrow) in the left kidney and multiple low density masses (arrowhead) in the right hepatic lobe. B. HRCT shows a round shaped nodule with surrounding ground glass attenuations (arrow) in the upper lobe of the right lung. C. Axial CT scan shows thrombosis in the left iliac vein (arrow) without evidence of iliac vein compression syndrome by right common iliac artery (white arrow head). D. Venography obtained after thrombolytic therapy shows improvement of thrombosis without evidence of stenosis in the left iliac vein. IVC filter was removed 5 days later. E. Follow-up CT after 2 month shows patent lumen of the left iliac vein.

Reference

1. Bain BJ. Hypereosinophilia. Curr Opin Hematol. 2000; 7:21–25.

2. Mohri H, Motomura S, Okubo T. Unusual leukocytosis with eosinophilia by an allergic disease. Am J Hematol. 1998; 57:90–91.

3. Kim SH, Kim TB, Yun YS, Shin JI, Oh IY, Sir JJ, et al. Hypereosinophilia presenting as eosinophilic vasculitis and multiple peripheral artery occlusions without organ involvement. J Korean Med Sci. 2005; 20:677–679.

4. Merkel PA, Lo GH, Holbrook JT, Tibbs AK, Allen NB, Davis JC Jr, et al. Brief communication: high incidence of venous thrombotic events among patients with Wegener granulomatosis: the Wegener's Clinical Occurrence of Thrombosis (WeCLOT) study. Ann Intern Med. 2005; 142:620–626.

5. Hachulla E, Hatron PY, Janin A, Robert Y, Devulder B. Digital arteritis, thrombosis and hypereosinophilic syndrome: an uncommon complication. Rev Med Interne. 1995; 16:434–436.

6. Ferguson GT, Starkebaum G. Thromboangiitis obliterans associated with idiopathic hypereosinophilia. Arch Intern Med. 1985; 145:1726–1728.

7. Song JK, Jung SS, Kang SW. Two cases of eosinophilic vasculitis with thrombosis. Rheumatol Int. 2008; 28:371–374.

8. Liao YH, Su YW, Tsay W, Chiu HC. Association of cutaneous necrotizing eosinophilic vasculitis and deep vein thrombosis in hypereosinophilic syndrome. Arch Dermatol. 2005; 141:1051–1053.

9. Pagnoux C, Guilpain P, Guillevin L. Churg-Strauss syndrome. Curr Opin Rheumatol. 2007; 19:25–32.

10. Kanno H, Ouchi N, Sato M, Wada T, Sawai T. Hypereosinophilia with systemic thrombophlebitis. Hum Pathol. 2005; 36:585–589.