Topical steroids in the management of Churg-Strauss syndrome involving the conjunctiva.
OBJECTIVE
To discuss a case of Churg-Strauss syndrome that developed bilateral conjunctival involvement while recovering from miliary tuberculosis.


METHODS
Case report and literature review.


RESULTS
A 22-year-old man who was on oral prednisolone for Churg-Strauss syndrome since 2002 contracted miliary tuberculosis in June 2004. The diagnosis was confirmed by liver biopsy. Ophthalmologic examination was within reference limits except for bilateral multifocal choroiditis. A combined therapy of rifampicin, ethambutol, streptomycin, and morphazinamide was started on June 24, 2004. Complete recovery was achieved, and the antituberculosis therapy was terminated in June 2005. The patient noted redness and pain in both eyes a month later. He had bilateral irregular, pink-yellow, gravel-like infiltrations involving the bulbar conjunctiva. Biopsy revealed granulomas with central fibrinoid necrosis, histiocytes, and eosinophils, suggestive of conjunctival involvement of Churg-Strauss syndrome. Topical dexamethasone 0.1% drops were started 4 times per day and tapered gradually. Lesions totally regressed within 2 months. No recurrence was noted during a follow-up of 11 months.


CONCLUSIONS
Churg-Strauss syndrome may rarely involve the conjunctiva, and conjunctival lesions respond favorably to topical steroids.
Yaman
Aylin
A
Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Ozbek
Zeynep
Z
Saatci
Ali Osman
AO
Durak
Ismet
I
Lebe
Banu
B
D000287:Administration, Topical; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D015267:Churg-Strauss Syndrome / Q000188:drug therapy*; D003229:Conjunctival Diseases / Q000188:drug therapy*; D003907:Dexamethasone / Q000008:administration & dosage*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D014391:Tuberculosis, Miliary / Q000150:complications / Q000188:drug therapy
D000995:Antitubercular Agents; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D003907:Dexamethasone