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Korean J Asthma Allergy Clin Immunol. 2010 Dec;30(4):314-319. Korean. Case Report.
Na SY , Jeon SY , Kim YJ , Park JW , Jeong SH , Lee SP , Sung YM , Park S .
Department of Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea. allergy21@hotmail.com
Department of Radiology, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea.
Department of Pathology, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea.
Abstract

Churg-Strauss syndrome is a rare syndrome that is characterized by hypereosinophilic systemic necrotizing vasculitis affecting small- to medium-sized arteries and veins. The manifestations of multiple tracheobronchial mucosal lesion and thrombus of left ventricle are rarely reported in Churg-Strauss syndrome. We report a case of Churg-Strauss syndrome with diffuse tracheobronchial mucosal lesions in a 52-year-old man who developed a left ventricular thrombus after discontinuation of treatment. Bronchial asthma, rhinosinusitis, peripheral eosinophilia, p-ANCA positive, eosinophilic lung infiltration, vasculitis led to a diagnosis of Churg-Strauss syndrome. On bronchoscopic evaluation, diffuse necrotizing mucosal lesions were observed on tracheobronchial tree. With methylprednisolone (125 mg/day), his asthmatic symptoms were well-controlled and eosinophil count and eosinophil cationic protein concentration in peripheral blood maintained in normal ranges over a 20 month period, but he was lost to follow-up. After 12 months from discontinuation of treatment he readmitted with relapsed Churg-Strauss syndrome with left ventricular thrombus. The thrombus gradually disappeared after prednisolone (1 mg/kg/day) and warfarin treatment.

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