Treatment of Churg-Strauss syndrome with an inhaled corticosteroid after oral steroids discontinuation due to side effects.
Churg-Strauss syndrome is characterized by a history of asthma, peripheral blood and tissue eosinophilia, with a predilection to the lungs. In this article we present a case of a 35 years old patient admitted to the hospital as a case of severe asthma apparently complicated by bilateral pneumonia. After a transient improvement on antibiotics, the respiratory symptoms recurred one month later in an exacerbated form. The diagnosis of Churg-Strauss syndrome was established on a clinical basis and a long-term therapy with oral corticosteroids and cyclophosphamide was introduced. The treatment must have been withdrawn after a year, because of a whole range of adverse effects, even though there was a severe recurrence of symptoms during the therapy. A regimen of the inhaled corticosteroid ciclesonide was then started, which entirely prevented the recurrence of respiratory symptoms over a two year follow-up period.
Swietlik
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E
Department of Internal and Pulmonary Medicine, Miedzyleski Hospital, Warsaw, Poland. em_swietlik@wp.pl
Doboszynska
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A
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D015267:Churg-Strauss Syndrome / Q000188:drug therapy* / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005271:Femur Head Necrosis / Q000139:chemically induced / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D009298:Nasal Polyps / Q000473:pathology; D009336:Necrosis; D011282:Pregnenediones / Q000008:administration & dosage / Q000627:therapeutic use; D012867:Skin / Q000473:pathology; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D007166:Immunosuppressive Agents; D011282:Pregnenediones; D013256:Steroids; D003520:Cyclophosphamide; C120481:ciclesonide