Anterior ischemic optic neuropathy in Churg-Strauss syndrome.
A patient with a history of chronic rhinitis, sinusitis, and bronchial asthma developed a unilateral anterior ischemic optic neuropathy and a mild sensory motor neuropathy as the initial manifestation of systemic vasculitis. We made a probable diagnosis of Churg-Strauss syndrome. Fluorescein angiography showed delayed choroidal perfusion in both eyes. Marked eosinophilia, increased sedimentation rate, and elevated perinuclear anti-neutrophil cytoplasmic antibody and anti-myeloperoxidase antibody titers were the main laboratory abnormalities that supported this diagnosis. Therapy with high-dose methylprednisolone and cyclophosphamide may have preserved vision in the better seeing eye, improved its choroidal circulation, and reversed the laboratory abnormalities except for a mild persistent eosinophilia. The neuropathy is gradually improving.
Department of Neurology, Georgetown University School of Medicine, Washington, DC 20007.
J C
JC
Kattah
G A
GA
Chrousos
P A
PA
Katz
B
B
McCasland
M P
MP
Kolsky
D000284:Administration, Oral; D001766:Blindness / Q000188:drug therapy / Q000209:etiology; D015267:Churg-Strauss Syndrome / Q000150:complications* / Q000175:diagnosis; D003520:Cyclophosphamide / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D006801:Humans; D007511:Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D009900:Optic Nerve / Q000098:blood supply* / Q000000981:diagnostic imaging; D011241:Prednisone / Q000008:administration & dosage; D011859:Radiography
D003520:Cyclophosphamide; D011241:Prednisone; D008775:Methylprednisolone