Bili A, Condemi J J, Bottone S M, Ryan C K
Allergy/Immunology/Rheumatology Unit, University of Rochester, Rochester, NY 14642, USA.
J Allergy Clin Immunol. 1999 Nov;104(5):1060-5. doi: 10.1016/s0091-6749(99)70089-8.
Various forms of Churg-Strauss syndrome have been reported in association with the use of leukotriene receptor antagonists in asthmatic patients.
Our purpose was to increase awareness that different forms of the Churg-Strauss syndrome occur in patients not receiving leukotriene modifiers.
We searched for all the cases of Churg-Strauss syndrome that were seen in the University of Rochester Medical Center, New York, in the past 4 years.
We identified 7 patients, 6 of whom fulfilled the American College of Rheumatology criteria for the classification of Churg-Strauss syndrome. None of them used leukotriene receptor antagonists. All had asthma and sinus disease. The duration and severity of their asthma varied considerably. In the majority of the patients the features of Churg-Strauss syndrome became obvious as the systemic corticosteroid dose was being tapered or discontinued, although 3 patients had not been receiving maintenance oral corticosteroids at disease onset. Three patients had positive antineutrophil cytoplasmic antibodies test result (perinuclear pattern). There was histologic documentation of vasculitis in 4 patients. Five of 7 patients responded to high-dose corticosteroid treatment.
Our 7 cases are similar to the various forms of Churg-Strauss syndrome that have been reported in association with the leukotriene receptor antagonists. Complete or incomplete forms of this syndrome can become apparent in asthmatic patients as systemic corticosteroids are being tapered but can also occur in patients with mild asthma of short duration who use only inhaled corticosteroids.
已有报道称，哮喘患者使用白三烯受体拮抗剂后会出现多种形式的变应性肉芽肿性血管炎。
我们旨在提高人们对未接受白三烯调节剂治疗的患者会出现不同形式变应性肉芽肿性血管炎的认识。
我们检索了纽约罗切斯特大学医学中心在过去4年中诊治的所有变应性肉芽肿性血管炎病例。
我们确定了7例患者，其中6例符合美国风湿病学会变应性肉芽肿性血管炎分类标准。他们均未使用白三烯受体拮抗剂。所有患者均患有哮喘和鼻窦疾病。他们哮喘的病程和严重程度差异很大。大多数患者在全身用糖皮质激素剂量逐渐减少或停用过程中，变应性肉芽肿性血管炎的特征变得明显，不过有3例患者在疾病发作时未接受口服糖皮质激素维持治疗。3例患者抗中性粒细胞胞浆抗体检测结果呈阳性（核周型）。4例患者有血管炎的组织学证据。7例患者中有5例对大剂量糖皮质激素治疗有反应。
我们的7例病例与报道的与白三烯受体拮抗剂相关的多种形式的变应性肉芽肿性血管炎相似。在哮喘患者中，随着全身用糖皮质激素逐渐减量，该综合征的完全型或不完全型可能会显现，但也可能发生在仅使用吸入性糖皮质激素的病程短的轻度哮喘患者中。
