Kaul Anupma, Sharma Raj Kumar, Jaisuresh Krishna Swamy, Agrawal Vinita
Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Saudi J Kidney Dis Transpl. 2014 Mar;25(2):402-7. doi: 10.4103/1319-2442.128580.
A 58-year-old male presented with sensory motor polyneuropathy and rapidly progressive renal failure. Investigations revealed marked peripheral eosinophilia and elevated perinuclear antineutrophil cytoplasmic antibody titers. Renal biopsy showed pauci-immune cre-scentic glomerulonephritis with interstitial eosinophil infiltrates. He had no history of asthma. Computed tomography of the chest and X-ray of the paranasal sinuses were normal. On Day 1, the patient developed ileal perforation. Resected ileal segments showed small vessel vasculitis with extravascular eosinophils. A diagnosis of non-asthmatic variant of Churg-Strauss syndrome was made. Renal recovery was achieved in 12 weeks with a combination therapy of corticosteroid and cyclophosphamide. The patient has been relapse-free for 12 months on oral prednisolone therapy.
一名58岁男性出现感觉运动性多发性神经病和快速进展的肾衰竭。检查发现外周血嗜酸性粒细胞显著增多以及核周抗中性粒细胞胞浆抗体滴度升高。肾活检显示寡免疫性新月体性肾小球肾炎伴间质嗜酸性粒细胞浸润。他没有哮喘病史。胸部计算机断层扫描和鼻窦X线检查均正常。第1天，患者出现回肠穿孔。切除的回肠段显示小血管血管炎伴血管外嗜酸性粒细胞。诊断为Churg-Strauss综合征的非哮喘变异型。通过皮质类固醇和环磷酰胺联合治疗，12周时肾功能恢复。患者口服泼尼松龙治疗12个月无复发。
