title: A case of montelukast-induced churg-strauss syndrome associated with liver dysfunction.
abstract: A 64-year-old woman was admitted to hospital due to protracted diarrhea and liver dysfunction. The patient was diagnosed as Churg-Strauss syndrome (CSS) due to asthma, paranasal sinusitis, hypereosinophilia, and polyneuropathy. There was a history of taking montelukast, a leukotriene receptor antagonist (LTRA), which is thought to have some relationship with CSS. The liver biopsy specimen showed eosinophilic infiltration and centrolobular fatty change. In this paper, we review the relationship between LTRA and CSS. Several lines of evidence suggest that leukotriene plays an important role in maintaining neural tissues. We also review the potential relationship between centrolobular fatty change and pivoxil-containing antibiotics, which was prescribed for sinusitis before admission. Carnitine deficiency induced by pivoxil-containing agents may cause impaired fatty acid oxidation in mitochondria.
authors.affiliation: Center for Digestive and Liver Disease, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-city, Kanagawa 247-0056, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsui
authors.affiliation: Kamakura Internal Medicine Clinic, 736 Yamanouchi, Kamakura-city, Kanagawa 247-0062, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Nishijima