Successful treatment of a patient with severe Churg-Strauss syndrome by a combination of pulse corticosteroids, pulse cyclophosphamide, and high-dose intravenous immunoglobulin

• Published in: The Journal of asthma Vol. 42; no. 8; p. 639
• Main Authors: Takigawa, Nagio, Kawata, Noriko, Shibayama, Takuo, Tada, Atsuhiko, Kimura, Goro, Munemasa, Mitsuru, Soda, Ryo, Takahashi, Kiyoshi
• Format: Journal Article
• Language: English
• Published: England 01.01.2005
• Subjects: Adrenal Cortex Hormones - therapeutic use; Adult; Asthma - drug therapy; Churg-Strauss Syndrome - drug therapy; Cyclophosphamide - therapeutic use; Drug Therapy, Combination; Female; Humans; Immunoglobulins, Intravenous - administration & dosage; Immunologic Factors - administration & dosage; Immunosuppressive Agents - therapeutic use; Severity of Illness Index
• ISSN: 0277-0903
• DOI: 10.1080/02770900500263822

A 24-year-old woman with a 4-year history of bronchial asthma suffered from bloody sputum, numbness of the extremities, elevated eosinophil count, and hypoxemia. A diagnosis of alveolar hemorrhage was made by bronchoalveolar lavage. Echocardiogram revealed severe hypokinesis of the left ventricular wall. Her respiratory condition deteriorated despite administration of pulse corticosteroids. A second pulse corticosteroids and pulse cyclophosphamide followed by high-dose intravenous immunoglobulin brought about a dramatic improvement of alveolar hemorrhage, cardiac impairment, and peripheral neuropathy. Levels of antimyeloperoxidase-antineutrophil cytoplasmic antibodies, soluble thrombomodulin, soluble interleukin-2 receptor, eosinophil cationic protein were elevated and returned to the normal range in remission. The combination of pulse corticosteroids, pulse cyclophosphamide, and high-dose intravenous immunoglobulin seemed effective for the acute phase of severe Churg-Strauss syndrome.