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Repressed ileal artery aneurysms in Churg-Strauss syndrome following combination treatment with glucocorticoid and cyclophosphamide

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Abstract

Churg-Strauss syndrome (CSS) is a systemic small-vessel vasculitis characterized by asthma and eosinophilia. We report a case of CSS complicated by multiple aneurysms in the small intestine. A 57-year-old man was admitted to our hospital with fever and blood eosinophilila. During admission, aneurysms in his small intestine ruptured and partial resection of the small intestine was required. After combination therapy of glucocorticoid (GC) and cyclophosphamide (CYC) for 6 months, aneurysms in the small intestine disappeared. The gastrointestinal involvements usually result in poor prognosis in CSS. However, combination therapy of GC and CYC might be effective for remission of aneurysms caused by small vessel vasculitis.

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References

  1. Noth I, Strek ME, Leff AR (2003) Churg-Strauss syndrome. Lancet 361(9357):587–594

    Article  PubMed  Google Scholar 

  2. Churg J, Strauss L (1951) Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am J Pathol 27(2):277–301

    PubMed  CAS  Google Scholar 

  3. Levine SM, Hellmann DB, Stone JH (2002) Gastrointestinal involvement in polyarteritis nodosa (1986–2000): presentation and outcomes in 24 patients. Am J Med 112(5):386–391

    Article  PubMed  Google Scholar 

  4. Travers RL et al (1979) Polyarteritis nodosa: a clinical and angiographic analysis of 17 cases. Semin Arthritis Rheum 8(3):184–199

    Article  PubMed  CAS  Google Scholar 

  5. Wold LE, Baggenstoss AH (1949) Gastrointestinal lesions of periarteritis nodosa. Mayo Clin Proc 24(2):28–35

    PubMed  CAS  Google Scholar 

  6. Fraioli P, Barberis M, Rizzato G (1994) Gastrointestinal presentation of Churg Strauss syndrome. Sarcoidosis 11(1):42–45

    PubMed  CAS  Google Scholar 

  7. Camilleri M et al (1983) Gastrointestinal manifestations of systemic vasculitis. Q J Med 52(206):141–149

    PubMed  CAS  Google Scholar 

  8. Masi AT et al (1990) The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 33(8):1094–1100

    PubMed  CAS  Google Scholar 

  9. Murakami S et al (2004) Churg-Strauss syndrome manifesting as perforation of the small intestine: report of a case. Surg Today 34(9):788–792

    Article  PubMed  Google Scholar 

  10. Lin TL et al (2001) Multiple colonic ulcers caused by Churg-Strauss syndrome in a 15-year-old girl. Clin Rheumatol 20(5):362–364

    Article  PubMed  CAS  Google Scholar 

  11. Nakamura Y et al (2002) Multiple perforated ulcers of the small intestine associated with allergic granulomatous angiitis: report of a case. Surg Today 32(6):541–546

    Article  PubMed  Google Scholar 

  12. Karp DR et al (1988) Successful management of catastrophic gastrointestinal involvement in polyarteritis nodosa. Arthritis Rheum 31(5):683–687

    Article  PubMed  CAS  Google Scholar 

  13. Harada M et al (1999) Polyarthritis nodosa with mesenteric aneurysms demonstrated by angiography: report of a case and successful treatment of the patient with prednisolone and cyclophosphamide. J Gastroenterol 34(6):702–705

    Article  PubMed  CAS  Google Scholar 

  14. Fauci AS, Doppman JL, Wolff SM (1978) Cyclophosphamide-induced remissions in advanced polyarteritis nodosa. Am J Med 64(5):890–894

    Article  PubMed  CAS  Google Scholar 

  15. Raza K et al (2000) Dramatic aneurysm regression in polyarteritis nodosa following high dose pulse cyclophosphamide. J Rheumatol 27(5):1320–1321

    PubMed  CAS  Google Scholar 

  16. Kato H et al (1975) Coronary aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome. J Pediatr 86(6):892–898

    Article  PubMed  CAS  Google Scholar 

  17. Hunder G (1996) Vasculitis: diagnosis and therapy. Am J Med 100(2A):37S–45S

    Article  PubMed  CAS  Google Scholar 

  18. Lanham JG et al (1984) Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome. Medicine (Baltimore) 63(2):65–81

    CAS  Google Scholar 

  19. Stanson AW et al (2001) Polyarteritis nodosa: spectrum of angiographic findings. Radiographics 21(1):151–159

    PubMed  CAS  Google Scholar 

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Correspondence to Akira Yamasaki.

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Yamasaki, A., Tomita, K., Fujii, Y. et al. Repressed ileal artery aneurysms in Churg-Strauss syndrome following combination treatment with glucocorticoid and cyclophosphamide. Rheumatol Int 29, 335–337 (2009). https://doi.org/10.1007/s00296-008-0668-7

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  • DOI: https://doi.org/10.1007/s00296-008-0668-7

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