Cutaneous lesions of Churg-Strauss syndrome associated with montelukast therapy

Gal, Anthony A.; Morris, Robert J.; Pine, Jeffrey R.; Spraker, Mary K.

doi:10.1046/j.1365-2133.2002.48839.x

Cited by 15 publications

(3 citation statements)

References 7 publications

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“…Of these 48 cases, 22 (46%) were ANCA negative. Seventeen cases were p-ANCA positive, one was c-ANCA positive (1:640)18 and in eight the positive ANCA pattern was not specified. In 18 cases anti-myeloperoxidase ELISA was positive, in 22 it was negative and in 26 this was not reported.…”

Section: Resultsmentioning

confidence: 94%

Churg-Strauss syndrome and leukotriene antagonist use: a respiratory perspective

Nathani

Little

Kunst

et al. 2008

Thorax

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Section: Resultsmentioning

confidence: 94%

Churg-Strauss syndrome and leukotriene antagonist use: a respiratory perspective

Nathani

Little

Kunst

et al. 2008

Thorax

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“…Many cases of CSS have been reported during postmarketing surveillance of zafirlukast, 12,21-28 pranlukast, 20,29 -31 and montelukast, 9,20,28,[32][33][34][35][36][37][38][39][40][41] but only 1 such case has been mentioned after zileuton therapy, 9 but has not yet been published as a case report. Communications have indicated that more than 100 cases of CSS associated with LTRA have been reported to the US Food and Drug administration, 42,43 while their manufacturers have independently added a warning to the drug labels and have even issued a letter to physicians.…”

Section: Lma and Css: Epidemiology And Characteristicsmentioning

confidence: 97%

Churg-Strauss Syndrome and Leukotriene-Modifying Agents

Pagnoux¹,

Guilpain²,

Hauser³

et al. 2004

Clinical Pulmonary Medicine

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Churg-Strauss syndrome (CSS) is a primary systemic necrotizing vasculitis of unknown origin, which is typically characterized by the association of asthma and blood eosinophilia. Leukotriene-modifying agents include zileuton, a 5-lipoxygenase inhibitor, and 3 selective leukotriene type 1 receptor antagonists (LTRA: zafirlukast, montelukast, and pranlukast) that have all been approved for the treatment of persistent asthma. Since 1996, when the first LTRA became available, more than 100 cases of CSS possibly related to LTRA use have been recorded by the US Food and Drug administration, and more than 50 cases have been described in the literature. These CSS developed 2 days to 15 months after LTRA introduction. Their clinical and biologic manifestations were similar to those of CSS occurring independently of LTRA use; however, the former may develop more often cardiomyopathy, but neuropathy and anticytoplasmic autoantibodie positivity less frequently than in the latter form of CSS. Notably, outcome after LTRA discontinuation and under systemic steroid therapy was usually good. These cases of CSS may result from the unmasking of an underlying incipient "forme fruste" of the vasculitis, during the steroid withdrawal or tapering made possible by LTRA therapy, or from a direct causal role of LTRA. Pertinently, these hypotheses are not exclusive and, until further studies clarify this point, the wisest strategy seems to be to discontinue or avoid their use in CSS patients, to carefully monitor asthmatic patients taking these drugs and to remember that CSS onset may resemble a worsening of persistent mild or severe asthma.

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“…Although in some cases CSS appears related to reducing or tapering steroid dosage, several authors suggest that the drug may have a direct causative role (idiosyncratic drug reaction or drug allergy) in activating this condition. 13,14…”

Section: Discussionmentioning

confidence: 99%