Bowel perforations in a patient affected by Churg-Strauss syndrome under high-dose steroid treatment: will alternative drugs reduce risk of surgery?
Churg-Strauss syndrome is a relapsing-remitting vasculitis that frequently involves digestive system. Ischemic perforation of the large bowel is relatively rare and potentially life threatening. We report a case treated with high dose of steroids for a relapsing of Churg-Strauss vasculopathy that underwent emergency surgery for multiple large-bowel perforations. Massive use of steroids is common for controlling relapse of this disease, but this increases the risk of intestinal perforation. A prompt switching to alternative drugs when intestinal tract is involved should be considered in order to prevent surgery.
Venditti
Dario
D
Department of Emergency Surgery, Policlinico Tor Vergata, Tor Vergata University Hospital, Rome, Italy.
Valerio
Balassone
B
Ielpo
Benedetto
B
Buonomo
Oreste
O
Petrella
Giuseppe
G
D015746:Abdominal Pain / Q000175:diagnosis / Q000601:surgery; D000208:Acute Disease; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015267:Churg-Strauss Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D003108:Colonic Diseases / Q000139:chemically induced* / Q000517:prevention & control; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007081:Ileostomy; D007416:Intestinal Perforation / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy; D012131:Respiratory Insufficiency / Q000175:diagnosis; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D008775:Methylprednisolone