title: Churg Strauss syndrome after introducing oral steroid to inhaler: a report of three cases.
abstract: The tetrad of bronchial asthma, severe sinusitis, nasal polyp, eosinophilia, and systemic vasculitis is the main feature of allergic granulomatosis and angitis (Churg- Strauss Syndrome). This vasculitis is usually seen idiopathic in patients with a long history of asthma; oral steroids using steroid inhalers, vaccination and desensitization might be triggering factors. Drugs such as leukotriene receptor antagonists (LTRAS), penicillin, sulphonamides, anticonvulsants and thiazides have also been implicated. By presenting the cases in this article, the authors suggest that some cases of CSS may be partially or totally suppressed by corticosteroid therapy of asthma for long periods and replacing oral steroid by inhaler will reveal a pathologic condition of CSS, called frustes CSS forms. We report three subjects with asthma who had been receiving previously multiple corticosteroid courses for control, but when systemic corticosteroids were discontinued or switched over to steroid inhaler, the patients developed a similar syndrome.
authors.affiliation: Department of Internal Medicine, National research institute of Tuberculosis and ling Disease (NRITLD), School of Medicine, Shaheed Beheshti University of Medical Sciences and Health Care, Tehran, Iran. saeid_ftafti@yahoo.com
authors.forename: Saeid
authors.initials: S
authors.lastname: Fallah-Tafti
authors.forename: Davoud
authors.initials: D
authors.lastname: Mansouri
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Masjedi
authors.forename: Mehran
authors.initials: M
authors.lastname: Marashian
authors.forename: Delara
authors.initials: D
authors.lastname: Faridian
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D000328:Adult; D001249:Asthma / Q000188:drug therapy*; D015267:Churg-Strauss Syndrome / Q000139:chemically induced* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000305:Adrenal Cortex Hormones