Ozlen Burcu, Ozdemir Levent, Eskitütüncü Banu, Cevirme Leyla, Kurtar Nazan, Soy Mehmet, Hatipoğlu Osman Nuri
Department of Chest Diseases, Faculty of Medicine, Trakya University, and Keşan Government Hospital, Edirne, Turkey.
Tuberk Toraks. 2008;56(4):434-8.
A 47 year old woman who had a history of asthma for 15 years referred to our hospital because of infiltrates on her chest radiograph that not responded to antibiotic treatment. We found that she had eosinophilia in peripheral blood (38%) and bronchoalveolar lavage (54%), nasal polyposis, and transient pulmonary infiltrates, and in the base of these findings we diagnosed as Churg-Strauss Syndrome (CSS). She has been using montelukast for 2 years. By examining her previous medical records, we observed that while eosinophil rates in peripheral blood were normal before montelukast usage, after this therapy eosinophil rates were greater 10 percent. Therefore, we thought that CSS was to be associated with montelukast usage. After just montelukast therapy was discontinued, clinical and radiographic parameters and the eosinophil counts (20%) improved. We present this case of CSS associated with montelukast in whom spontaneous remission was observed without using corticosteroids and cytotoxic agents.
一名有15年哮喘病史的47岁女性因胸部X光片上的浸润影对抗生素治疗无反应而转诊至我院。我们发现她外周血嗜酸性粒细胞增多(38%),支气管肺泡灌洗中嗜酸性粒细胞增多(54%),有鼻息肉和短暂性肺部浸润影,基于这些发现我们诊断为变应性肉芽肿性血管炎(CSS)。她使用孟鲁司特已2年。通过查阅她之前的病历,我们观察到在使用孟鲁司特之前外周血嗜酸性粒细胞率正常,而在该治疗后嗜酸性粒细胞率增加了10%以上。因此,我们认为CSS与使用孟鲁司特有关。仅停用孟鲁司特治疗后,临床和影像学参数以及嗜酸性粒细胞计数(20%)就有所改善。我们报告这例与孟鲁司特相关的CSS病例,该病例在未使用皮质类固醇和细胞毒性药物的情况下出现了自发缓解。