Tanaka Y, Muto H, Akiyama N, Arai Y, Miyamoto Y, Sano Y
Department of Allergy and Respiratory Disease, Doai Memorial Hospital, Tokyo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Sep;32(9):873-7.
A 68-year-old woman with bronchial asthma and a history of drug hypersensitivity came to our hospital because of severe pain, swelling, and ecchymoses in the lower extremity. The eosinophil count was 53.5%, therefore Churg-Strauss syndrome was diagnosed and she was given prednisolone (PSL) (30 mg/day). A skin specimen taken the next day showed tissue eosinophilia, acute and subacute necrotizing vasculitis. Immunofluorescence staining showed IgG in the blood vessels. After one month of PSL, biopsy specimens of muscle fiber revealed atrophy of type IIb fibers, and myxomatous degeneration of neuron-fibers. Eosinophilia decreased rapidly after administration of PSL, but the necrotizing lesions of the skin, muscle, and nerve were so severe that she needed orthopedic shoes.