Churg-Strauss syndrome: 2005–2008 update

Churg-Strauss syndrome (CSS) is a rare necrotizing small-vessel vasculitis associated with eosinophil-rich granulomatous inflammation of tissues and vessels and is also associated with asthma and eosinophilia. Epidemiologic studies continue to show that CSS is the rarest of the necrotizing small-ves...

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Bibliographic Details
Published inCurrent rheumatology reports Vol. 10; no. 6; pp. 453 - 458
Main Author Grau, Rafael G.
Format Journal Article
LanguageEnglish
Published New York Current Science Inc 01.12.2008
Subjects
Antibodies, Antineutrophil Cytoplasmic - blood
Churg-Strauss Syndrome - drug therapy
Churg-Strauss Syndrome - mortality
Churg-Strauss Syndrome - pathology
Churg-Strauss Syndrome - physiopathology
Cyclophosphamide - therapeutic use
Glucocorticoids - therapeutic use
Humans
Immunosuppressive Agents - therapeutic use
Medicine
Medicine & Public Health
Rheumatology
Survival Rate
Omalizumab
Central Retinal Artery Occlusion
Vasculitis
Antineutrophil Cytoplasmic Antibody
Serum Vascular Endothelial Growth Factor
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Summary:Churg-Strauss syndrome (CSS) is a rare necrotizing small-vessel vasculitis associated with eosinophil-rich granulomatous inflammation of tissues and vessels and is also associated with asthma and eosinophilia. Epidemiologic studies continue to show that CSS is the rarest of the necrotizing small-vessel vasculitides. However, it is not possible to know with any certainty if there has been an increase in incidence. There has been an attempt to divide the patients with CSS into an antineutrophil cytoplasmic antibody-positive and cytoplasmic antibody-negative group. The former group has an increased frequency of renal involvement, parenchymal pulmonary disease, constitutional symptoms, and peripheral and central nervous system involvement, whereas the latter group has more frequent cardiac disease. The role of eosinophils and antineutrophil cytoplasmic antibodies remains poorly defined but provocative. Leukotriene receptor antagonists do not appear to induce CSS but facilitate the tapering of glucocorticoids, which unmasks the condition. Glucocorticoids and cyclophosphamide remain the foundation of treatment for vasculitis, but there are other promising and less toxic alternatives on the horizon.
ISSN:1523-3774
1534-6307
DOI:10.1007/s11926-008-0074-x