Montelukast and Churg-Strauss Syndrome

A 37-year-old asthmatic presented with arthralgia, dyspnea, hemo­ptysis, wheezing, abdominal pain, and eosinophilia. He did not re­ceive any corticosteroid therapy previously and five weeks prior to admission Montelukast was started. Transthoracic echocardiography showed severely depressed left ventricular function with an ejection fraction of 20-25%. By the diagnosis of Montelukast-assoclated Churg- Strauss syndrome with cardiac involvement, the drug was stopped and steroids started. During the follow up period of 3 years, he did not have an other vasculitic episode. Although this is a rare association, the clinicians need to be vigilant in all patients who develop systemic symptoms when starting treatment with leukotriene antagonists.