Churg-Strauss syndrome (allergic granulomatous antiitis) with multiple perforating ulcers of the small intestine, multiple ulcers of the colon, and mononeuritis multiplex

Masahiro Kurita, Yasuro Niwa, Eiji Hamada, Yasuo Hata, Masamichi Oshima, Hiroyuki Mutoh, Shuichiro Shina, Ryo Nakata, Shinichi Ota, Akira Terano, Tsuneaki Sugimoto, Masaya Ono, Toshio Sawada, Masaki Mori, Toshirou Niki, Teruaki Oka

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Abstract

A case of Churg-Strauss syndrome with multiple perforations of the small intestine is described. A 31-year-old woman was admitted with a complaint of epigastric pain. She had a history of bronchial asthma. One week before admission, white blood cell count was 20 800/mm3 with 59% eosinophils. Neurological examination on admission disclosed mononeuritis multiplex with paresthesia in both the lower and upper extremities. At colonoscopy, there were scattered aphthous ulcers in the colon. Ophthalmological examination revealed allergic conjunctivitis. After admission, hypereosinophilia increased to as high as 36 000/mm3. Oral administration of prednisolone (60 mg/day) was begun. On the 3rd day of the treatment, the eosinophil count decreased dramatically, to 400/mm3, while severe abdominal pain developed. Since abdominal X-ray film revealed free air in the abdominal cavity, emergency laparotomy was performed and multiple intestinal ulcers with perforations were found. Partial ileectomy was performed. Pathological findings of the resected specimen were interpreted as a necrotizing angiitis with extravascular granuloma. Since the operation, the patient has been asymptomatic, except for neurological symptoms. Hypereosinophilia has decreased without treatment to counts averaging 270/mm3, within 3 months. On the basis of the clinical features and histopathological findings, a diagnosis of Churg-Strauss syndrome was established.

Original languageEnglish
Pages (from-to)208-213
Number of pages6
JournalJournal of gastroenterology
Volume29
Issue number2
DOIs
Publication statusPublished - Mar 1 1994
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Gastroenterology

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