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 language | English |
|---|---|
| Pages (from-to) | 215-218 |
| Number of pages | 4 |
| Journal | Acta Medica Okayama |
| Volume | 65 |
| Issue number | 3 |
| Publication status | Published - Jun 2011 |
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Keywords
- Bronchial asthma
- Churg-strauss syndrome
- Eosinophilia
- Necrosis of toe tips
- Stump plasty
ASJC Scopus subject areas
- Medicine(all)
- Biochemistry, Genetics and Molecular Biology(all)
Cite this
Churg-strauss syndrome with necrosis of toe tips. / Waseda, Koichi; Tanimoto, Yasushi; Hasegawa, Kenjiro; Miyahara, Nobuaki; Nojima, Daisuke; Ikeda, Genyo; Kanehiro, Arihiko; Okada, Chiharu; Kimata, Yoshihiro; Tanimoto, Mitsune.
In: Acta Medica Okayama, Vol. 65, No. 3, 06.2011, p. 215-218.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Churg-strauss syndrome with necrosis of toe tips
AU - Waseda, Koichi
AU - Tanimoto, Yasushi
AU - Hasegawa, Kenjiro
AU - Miyahara, Nobuaki
AU - Nojima, Daisuke
AU - Ikeda, Genyo
AU - Kanehiro, Arihiko
AU - Okada, Chiharu
AU - Kimata, Yoshihiro
AU - Tanimoto, Mitsune
PY - 2011/6
Y1 - 2011/6
N2 - 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.
AB - 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.
KW - Bronchial asthma
KW - Churg-strauss syndrome
KW - Eosinophilia
KW - Necrosis of toe tips
KW - Stump plasty
UR - http://www.scopus.com/inward/record.url?scp=79960138887&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960138887&partnerID=8YFLogxK
M3 - Article
C2 - 21709721
AN - SCOPUS:79960138887
VL - 65
SP - 215
EP - 218
JO - Acta Medica Okayama
JF - Acta Medica Okayama
SN - 0386-300X
IS - 3
ER -