title: [Vasculitis associated with Churg-Strauss syndrome].
abstract: A 52-year-old man was admitted to hospital with abdominal pain, erythema and mild eosinophilia. Medical history revealed fatigue and dyspnoea on exertion after returning from the Gambia a year previously, and allergic rhinitis with nasal polyps that were surgically excised. Before a cause of the abdominal symptoms was determined he developed mononeuropathy, severe eosinophilia and arthralgia in combination with positive anti-neutrophil cytoplasmic antibodies (ANCA) against myeloperoxidase, which lead to the diagnosis of 'Churg-Strauss syndrome'. Despite treatment with high-dose corticosteroids (prednisone 1 mg/kg) his abdominal complaints intensified. A CT-scan of the abdomen showed a soft tissue mass around the caecum. Subsequent colonoscopy showed severe ulcerative lesions and signs of colonic ischemia. When PCR for cytomegalovirus appeared to be negative, treatment was intensified with cyclophosphamide 2 mg/kg, resulting in resolution of the abdominal complaints and healing of the ulcerative lesions in the colon.
authors.affiliation: Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Inwendige Geneeskunde en Klinische Immunologie en Reumatologie, Amsterdam, the Netherlands. r.klaasen@meandermc.nl
authors.forename: Ruth
authors.initials: R
authors.lastname: Klaasen
authors.forename: Bert-Jan H
authors.initials: BJ
authors.lastname: van den Born
authors.forename: Ruud J
authors.initials: RJ
authors.lastname: Loffeld
authors.forename: Mariette
authors.initials: M
authors.lastname: Grandiek
authors.forename: Daan M
authors.initials: DM
authors.lastname: Gerlag
authors.forename: Peter
authors.initials: P
authors.lastname: Hart
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis* / Q000209:etiology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015267:Churg-Strauss Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011241:Prednisone