바로가기메뉴

본문 바로가기 주메뉴 바로가기

Tuberculosis & Respiratory Diseases

Article Contents

Prev Next
e-Submission

Vol.66 No.3
Citation Share

A Case of Churg-Strauss Syndrome with Diffuse Alveolar Hemorrhage Presenting as Acute Acalculous Cholecystitis

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2009, v.66 no.3, pp.225-229







& (2009). A Case of Churg-Strauss Syndrome with Diffuse Alveolar Hemorrhage Presenting as Acute Acalculous Cholecystitis. Tuberculosis & Respiratory Diseases, 66(3), 225-229.
  • Downloaded
  • Viewed
PDF Download

Abstract

Churg-Strauss syndrome (CSS) is a disorder that is characterized by asthma, hypereosinophilia and systemic vasculitis affecting a number of organs. The manifestations of acute cholecystitis and diffuse alveolar hemorrhage are rarely reported in CSS. A 22-year-old woman with bronchial asthma visited our hospital complaining of right upper quadrant pain with a sudden onset. The abdominal computed tomography (CT) scan revealed gall bladder edema consistent with acute cholecystitis. On the initial evaluation, marked hypereosinophilia was observed in the peripheral blood smear. The nerve conduction velocity measurements and a skin biopsy performed to confirm the organ involvement of disease indicated typical mononeuritis multiplex and necrotizing vasculitis, respectively, which was complicated with CSS. On the 12th hospital day, ground glass opacity and consolidations were newly developed on both lung fields. The bronchoalveolar lavage (BAL) fluid showed increasing bloody return in sequential aliquots that were characteristic of a diffuse alveolar hemorrhage. We report a case of CSS with acute cholecystitis and diffuse alveolar hemorrhage.

keywords
Churg-Strauss syndrome, Acute cholecystitis, Diffuse alveolar hemorrhage

Reference

1.

Churg J, Strauss L. Allergic granulomatosis, allergic angiitis and periarteritis nodosa. Am J Pathol 1951;27:277-301.

2.

Kurita M, Niwa Y, Hamada E, Hata Y, Oshima M, Mutoh H, et al. Churg-Strauss syndrome (allergic granulomatous angiitis) with multiple perforating ulcers of the small intestine, multiple ulcers of the colon, and mononeuritis multiplex. J Gastroenterol 1994;29:208-13.

3.

Suzuki M, Nabeshima K, Miyazaki M, Yoshimura H, Tagawa S, Shiraki K. Churg-Strauss syndrome complicated by colon erosion, acalculous cholecystitis and liver abscesses. World J Gastroenterol 2005;11:5248-50.

4.

Nishie M, Tomiyama M, Kamijo M, Kannari K, Tanosaki M, Baba M, et al. Acute cholecystitis and duodenitis associated with Churg-Strauss syndrome. Hepatogastroenterology 2003;50:998-1002.

5.

Rolla G, Tartaglia N, Motta M, Ferrero N, Bergia R, Guida G, et al. Warning nonrespiratory symptoms in asthma: catastrophic abdominal involvement in a case of Churg-Strauss syndrome. Ann Allergy Asthma Immunol 2007;98:595-7.

6.

Tatsukawa H, Nagano S, Umeno Y, Oribe M. Churgstrauss syndrome with cholecystitis and renal involvement. Intern Med 2003;42:893-6.

7.

Jung SH, Kim KH, Nam SM, Park HC, Chu HK, Whang IS, et al. A case of Churg-Strauss syndrome with manifestations of esophageal ulcer, acute acalculous cholecystitis and ischemic colitis. Korean J Med 1993;45:369-75.

8.

Kim MS, Cho YJ, Roh SH. A case of Churg-Strauss syndrome which first presented as acute cholecystitis. J Asthma Allergy Clin Immunol 2008;28:143-7.

9.

Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP, et al. The American college of rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 1990;33:1094-100.

10.

Clutterbuck EJ, Pusey CD. Severe alveolar haemorrhage in Churg-Strauss syndrome. Eur J Respir Dis 1987;71:158-63.

11.

Lai RS, Lin SL, Lai NS, Lee PC. Churg-Strauss syndrome presenting with pulmonary capillaritis and diffuse alveolar hemorrhage. Scand J Rheumatol 1998;27:230-2.

12.

Schnabel A, Reuter M, Csernok E, Richter C, Gross WL. Subclinical alveolar bleeding in pulmonary vasculitides: correlation with indices of disease activity. Eur Respir J 1999;14:118-24.

13.

Yoshihara K, Arimura Y, Kobayashi O, Minoshima S, Kobayashi M, Yomogita S, et al. Clinical study on five myeloperoxidase specific anti-neutrophil cytoplasmic antibody (MPO-ANCA) positive Churg-Strauss syndrome cases. Ryumachi 1998;38:696-704.

14.

Franssen C, Gans R, Kallenberg C, Hageluken C, Hoorntje S. Disease spectrum of patients with antineutrophil cytoplasmic autoantibodies of defined specificity: distinct differences between patients with anti-proteinase 3 and anti-myeloperoxidase autoantibodies. J Intern Med 1998;244:209-16.

15.

Guillevin L, Lhote F, Gayraud M, Cohen P, Jarrousse B, Lortholary O, et al. Prognostic factors in polyarteritis nodosa and Churg-Strauss syndrome. A prospective study in 342 patients. Medicine (Baltimore) 1996;75:17-28.

Tuberculosis & Respiratory Diseases

e-Submission OA Policy