Abstract

Churg Strauss Syndrome (CSS) is an uncommon systemic disease characterized by asthma, peripheral eosinophilia, eosinophilic tissue infiltration, necrotizing vasculitis. We present a patient with the diagnosis of the CSS. A 28-year-old male patient presented with asthma suggesting symptoms for 5 years, in addition to general symptoms for 6 months. Physical examination was normal except bilateral expiratory rhonchi. Electrocardiogram revealed sinusal tachycardia and ventricular extrasystoles. Laboratory examination showed high erythrocyte sedimentation rate and liver enzymes, peripheral leukocytosis, eosinophilia, high total immunoglobulin E. Rheumatoid factor and p-ANCA were found to be positive in serum. Pulmonary function test disclosed restrictive and obstructive ventilatory defect. Computerized tomography of the thorax showed non-homogenous parenchymal consolidation in the posterior segment of the right upper lobe and patchy consolidation in the middle lobe. Forty-two percent of the cells were eosinophils in the bronchoalveolar lavage fluid. Electromyography suggested mononeuritis multiplex. The diagnosis was made according to American Rheumatology Committee’s criteria and pathology of the lung biopsy obtained via thoracotomy. Corticosteroids and cyclophosphamide were administered. The clinical and laboratory parameters of the disease returned normal after therapy.