title: Neuro-muscular biopsy in Churg-Strauss syndrome: 24 cases.
abstract: Churg-Strauss syndrome (CSS) is a distinctive clinical entity in which systemic vasculitis, associated with eosinophilia, occurs almost exclusively in individuals with adult-onset asthma. The major complications of the condition result from damage to the lungs, heart, and peripheral nerves. Necrotizing vasculitis with eosinophils in the cellular infiltrate, vascular or perivascular infiltration by eosinophils in absence of vessel wall necrosis, extra-vascular eosinophil infiltrates, and vascular or extra-vascular granuloma are histopathological features supportive of CSS. As the peripheral nerve disease often dominates the clinical picture, the peripheral nerve biopsy may be decisive in establishing the diagnosis. In this retrospective study of neuro-muscular biopsies in 24 CSS cases, the authors give an extensive description of neuropathological lesions associated with this disorder. Fifteen patients (62.5%) exhibited eosinophils either in extra-vascular infiltrates or in vessel walls, and 6 of them (25%) had an associated necrotizing vasculitis. Granulomas were found in only 3 cases (12.5%). The clinical diagnosis of CSS was supported in 15 out of the 24 patients (62.5%), in the nerve in 2 cases (8.3%), in the muscle in 8 cases (33.3%), and in both nerve and muscle in 5 others (20.8%).
authors.affiliation: Department of Neuropathology BP 42, Victor Segalen-Bordeaux 2 University, 146 rue Léo-Saignat, 33076 Bordeaux cedex, France. anna.vital@chu-bordeaux.fr
authors.forename: Anne
authors.initials: A
authors.lastname: Vital
authors.forename: Claude
authors.initials: C
authors.lastname: Vital
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Viallard
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Ragnaud
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Canron
authors.forename: Alain
authors.initials: A
authors.lastname: Lagueny
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D015267:Churg-Strauss Syndrome / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology* / Q000601:surgery; D010525:Peripheral Nerves / Q000473:pathology* / Q000601:surgery / Q000648:ultrastructure; D012189:Retrospective Studies