Delayed relapse of Churg-Strauss syndrome manifesting as colon ulcers with mucosal granulomas: 3 cases

J Rheumatol. 2002 Feb;29(2):388-91.

Abstract

Churg-Strauss syndrome (CSS) is characterized by small vessel vasculitis and extravascular granulomas. The American College of Rheumatology classification criteria for CSS include asthma, eosinophili, and clinical manifestation of vasculitis. Gastrointestinal (GI) manifestations occur in 30% of patients, but are inaugural in only 16%. They denote vasculitis of the stomach and small bowel wall, and consist in protean, nonspecific pain. GI involvement is of adverse prognostic significance in CSS. Ulcer formation in the GI tract mucosa is a rarer manifestation, usually discovered upon laparotomy or autopsy. We describe 3 new cases of colonic ulcers in CSS. Unusual features were diagnosis of the ulcers during a delayed relapse and presence of eosinophilic granulomas within the mucosa.

Publication types

  • Case Reports

MeSH terms

  • Churg-Strauss Syndrome / complications
  • Churg-Strauss Syndrome / drug therapy
  • Churg-Strauss Syndrome / pathology*
  • Colon / pathology*
  • Cyclophosphamide / therapeutic use
  • Drug Therapy, Combination
  • Eosinophilic Granuloma / drug therapy
  • Eosinophilic Granuloma / etiology
  • Eosinophilic Granuloma / pathology*
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Intestinal Mucosa / pathology*
  • Male
  • Middle Aged
  • Recurrence
  • Ulcer / drug therapy
  • Ulcer / etiology
  • Ulcer / pathology*

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Cyclophosphamide