Churg-strauss syndrome with necrosis of toe tips

Koichi Waseda, Yasushi Tanimoto, Kenjiro Hasegawa, Nobuaki Miyahara, Daisuke Nojima, Genyo Ikeda, Arihiko Kanehiro, Chiharu Okada, Yoshihiro Kimata, Mitsune Tanimoto

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5 Citations (Scopus)

Abstract

Churg-Strauss syndrome (CSS) is a granulomatous necrotizing vasculitis of unknown etiology associated with bronchial asthma. Despite affecting small to medium-sized vessels, necrosis of the digits due to vasculitis is extremely rare. We report a case of CSS with necrosis of the toe tips. A 37-year-old woman with asthma, who had been diagnosed with CSS 2 years ago, was admitted to our hospital with an exacerbation of CSS. The patient had a high grade fever and complained of abdominal pain and numbness of the lower extremities. Blood examination revealed marked eosinophilia. The fever pattern, abdominal pain and blood eosinophilia showed improvement by combination treatment with prednisolone and cyclophosphamide. However, the color of her right toe tips changed, and necrosis finally resulted despite antithrombotic therapy. Arteriography showed narrowing of the dorsalis pedis artery and of the more peripheral arteries of her right leg. Stump plasty with negative pressure dressing therapy for the toe tips, but not amputation, was done to preserve the leg function. While numbness of the extremities remained, no recurrence of necrosis was seen. Clinicians need to be aware that rare complications of CSS, including necrosis of the digits, can occur.

Original languageEnglish
Pages (from-to)215-218
Number of pages4
JournalActa medica Okayama
Volume65
Issue number3
Publication statusPublished - Jun 1 2011

Keywords

  • Bronchial asthma
  • Churg-strauss syndrome
  • Eosinophilia
  • Necrosis of toe tips
  • Stump plasty

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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  • Cite this

    Waseda, K., Tanimoto, Y., Hasegawa, K., Miyahara, N., Nojima, D., Ikeda, G., Kanehiro, A., Okada, C., Kimata, Y., & Tanimoto, M. (2011). Churg-strauss syndrome with necrosis of toe tips. Acta medica Okayama, 65(3), 215-218.