Tanizawa Kiminobu, Kaji Yusuke, Tanaka Eisaku, Inoue Tetsuro, Sakuramoto Minoru, Minakuchi Masayoshi, Maeda Yuji, Maniwa Ko, Terada Kunihiko, Goto Shunsuke, Takeda Tomoshi, Okamoto Masaki, Hashimoto Seishu, Noma Satoshi, Kobashi Yoichiro, Taguchi Yoshio
Department of Respiratory Medicine, Tenri Hospital.
Intern Med. 2010;49(9):841-5. doi: 10.2169/internalmedicine.49.2839. Epub 2010 Apr 30.
We report a case of Churg-Strauss syndrome (CSS) presenting as a massive pleural effusion. A 52-year-old asthmatic Japanese woman presented with progressive dyspnea caused by an eosinophilic pleural effusion (EPE). She also had chronic sinusitis, skin lesions and blood eosinophilia, but no antineutrophil cytoplasmic antibodies. Skin biopsy and the late onset of mononeuritis multiplex led to the diagnosis of CSS. The pleural effusion resolved soon after corticosteroid treatment was started. CSS is rare as a cause of EPE, but should be included in the differential diagnosis of EPE in asthmatic patients. This is the first report showing that EPE can precede other vasculitic symptoms in CSS.
我们报告一例以大量胸腔积液为表现的变应性肉芽肿性血管炎（CSS）。一名52岁的日本哮喘女性因嗜酸性胸腔积液（EPE）出现进行性呼吸困难。她还患有慢性鼻窦炎、皮肤病变和血液嗜酸性粒细胞增多，但无抗中性粒细胞胞浆抗体。皮肤活检及迟发性多发性单神经炎导致CSS的诊断。开始使用皮质类固醇治疗后，胸腔积液很快消退。CSS作为EPE的病因较为罕见，但在哮喘患者EPE的鉴别诊断中应予以考虑。这是第一份显示EPE可先于CSS其他血管炎症状出现的报告。
