Churg A, Brallas M, Cronin S R, Churg J
Department of Pathology, University of British Columbia, Vancouver.
Chest. 1995 Aug;108(2):320-3. doi: 10.1378/chest.108.2.320.
We report 4 cases of Churg-Strauss syndrome (CSS) that occurred in patients being treated with corticosteroids for a diagnosis of asthma. One patient had asthma, eosinophilia, and eosinophilic lymphadenopathy that regressed with higher doses of corticosteroids. The second patient had both eosinophilic tissue infiltration and symptoms suggestive of vasculitis, while the remaining two patients had overt vasculitis; in all three, vasculitis developed after tapering or discontinuation of corticosteroid therapy. Two patients died of their disease. We have labelled these cases as formes frustes CSS. Our observations suggest that some cases of CSS may be partially or totally suppressed by corticosteroid therapy for asthma for very long periods and that asthmatic subjects maintained on low-dose corticosteroid therapy or asthmatic subjects whose corticosteroid doses are being tapered should be carefully monitored for the development of CSS signs and symptoms.
我们报告了4例在因哮喘接受皮质类固醇治疗的患者中发生的变应性肉芽肿性血管炎（CSS）。1例患者有哮喘、嗜酸性粒细胞增多和嗜酸性粒细胞性淋巴结病，在使用更高剂量皮质类固醇时病情缓解。第2例患者既有嗜酸性粒细胞组织浸润又有提示血管炎的症状，而其余2例患者有明显的血管炎；在这3例患者中，血管炎均在皮质类固醇治疗减量或停药后出现。2例患者死于该病。我们将这些病例标记为顿挫型CSS。我们的观察结果表明，某些CSS病例可能会被长期用于哮喘治疗的皮质类固醇疗法部分或完全抑制，对于维持低剂量皮质类固醇治疗的哮喘患者或正在减少皮质类固醇剂量的哮喘患者，应密切监测CSS体征和症状的出现。
