We report a 49 year old male patient who presented with swelling in both thighs without pain and dyspnea. Platelet count was low (13,000/mm3) with increased eosinophils (48.9%). Patient developed pulmonary embolism. His ADAMTS 13 level was low and was therefore diagnosed as TTP. Treatment given was corticosteroid and plasma exchange. After a year he developed a lump in the skull. Histopathology report revealed vasculitis. Due to presence of vasculitis (TTP) along with eosinophilia, patient was finally diagnosed as a case of Churg Strauss Syndrome (CSS).
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