Churg-Strauss Syndrome with Pleural Involvement.

Abstract

A 51-year-old Japanese man with Churg-Strauss Syndrome (CSS) diagnosed by pleural biopsy is described. He was hospitalized because of high fever and bilateral knee, elbow and shoulder joint pain. Chest roentgenogram and chest computed tomography (CT) scan revealed bilateral massive pleural effusion. Pleural biopsy revealed eosinophilic infiltration and necrotizing granulomas. Hewas treated with oral prednisolone and his symptoms improved. This is the first report of CSSdiagnosed by pleural biopsy. (Internal Medicine 39: 976-978, 2000)

Idiopathic eosinophilic pleurisy: A practical diagnostic approach

“…As for other etiologies of eosinophilic pleural effusion, connective tissue diseases including rheumatoid arthritis and ulcerative colitis, pulmonary embolism, benign asbestos pleural effusion and pancreatic diseases including acute pancreatitis account for a few percent of the etiologies of eosinophilic pleural effusions [ 1 , [9] , [10] , [11] ]. Importantly, in previous studies, around 20% of the cases were of unknown etiology, some of which might have been occult, rare differential diagnoses including hypereosinophilic syndrome, eosinophilic granulomatous polyangiitis, chronic eosinophilic pneumonia, chronic myeloid leukemia, human T-cell leukemia virus type 1 infection, drug-induced pleuritis, and parasitic infestations [ 1 , [12] , [13] , [14] , [15] , [16] , [17] , [18] ], although they should be diagnosed because they require specific treatments. Thus, it is necessary to have an approach to the investigation of the different causal etiologies of eosinophilic pleurisy taking into account their frequency, importance, and the ease of performance and invasiveness of the examinations.…”

Massive Eosinophilic Pleural Effusion Preceding Vasculitic Symptoms in Churg-Strauss Syndrome

“…1b) (11)(12)(13). In biopsy specimens of CSS, eosinophilic inflammation in the subpleural and interlobular connective tissue and lymphatic luminal dilatation has been reported (8,9). Marked extravascular infiltration of eosinophils in the pleura causes the development of EPE and also presents the early (prevasculitic) phase of the CSS.…”

Approach to Eosinophilic Pleural Effusions

“…Bunlar arasında romatoid artrit, Churg-Straus hastalığı, sistemik lupus eritamatozis, sarkoidoz ve kronik eozinofilik pnömoni sayılabilir (7,(27)(28)(29).…”