Rhinologic symptoms and quality-of-life in patients with Churg-Strauss syndrome vasculitis.

BACKGROUND

The purpose of this study was to investigate the presentation pattern, sinonasal symptoms, and quality of life (QOL) in patients with Churg-Strauss syndrome (CSS) vasculitis.

METHODS

A cross-sectional study was performed. Twenty-five patients with CSS belonging to a patient self-help group participated. Main outcome measures included mode of initial presentation, treatment, rhinologic symptoms, and disease-specific QOL (Sinonasal Outcome Test [SNOT-22] scores) and comparisons were made with general rhinosinusitis and other nasally affected vasculitis patients (Wegener's granulomatosis [WG]).

RESULTS

Overall, 80% of CSS patients had active sinonasal symptoms at the time of the study. Twenty-eight percent of CSS patients reported worsening of their nasal symptoms as the main event leading to their diagnosis. Forty-eight percent of CSS patients had undergone nasal surgery. Nasal symptoms that are of particular relevance to this patient group are nasal obstruction (95%), rhinorrhea (95%), anosmia (90%), and excessive sneezing (80%). Other symptoms included nasal crusting (75%), purulent nasal discharge (65%), and epistaxis (60%). SNOT-22 scores were significantly higher than normal, reaching average values similar to those of patients from the general rhinosinusitis population.

CONCLUSION

Sinonasal symptoms are common at initial presentation of CSS, emphasizing the role of otolaryngologists in its diagnosis. Overall, CSS-related sinonasal morbidity is significant and comparable with that of the general rhinosinusitis population. It predominantly results from symptoms of allergic rhinitis, but a significant proportion of CSS patients also report milder forms of crusting, epistaxis, and of purulent sinusitis, symptoms which are more commonly attributed to patients with WG.