Two Cases of Churg-Strauss Syndrome Presenting with Small Intestinal Perforations

Taro Oshikiri¹⁾²⁾, Fumitaka Nakamura¹⁾, Mitsuru Dohke¹⁾, Tomoshige Masuda¹⁾, Kyousuke Miyazaki¹⁾²⁾, Hiroyuki Kaneko¹⁾²⁾, Nobuichi Kashimura¹⁾, Osamu Matsunami¹⁾, Satoshi Kondo²⁾and Hiroyuki Katoh²⁾

Department of Surgery, Teine Keijinkai Hospital¹⁾ Second Department of Surgery, Hokkaido University Hospital²⁾

A 64-year-old woman admitted due to severe asthma was found to have vasculitis at muscle biopsy and eosinophilia and was diagnosed with Churg-Strauss syndrome (CSS). Despite steroid therapy, perforations of small intestine occurred 2 times a week, requiring emergency surgery. Worsening vasculitis led to gangrenous cholecystitis and gastrointestinal necrosis and bleeding, and the patient died despite emergency surgery. A 67-year-old man who had a history of asthma admitted due to lower limb listness was found in nerve biopsy to have eosinophilia and vasculitis and diagnosed with CSS. Ileac perforation following steroid pulse therapy necessitated emergency surgery. Pathological findings indicated angitis in both cases despite preoperative steroid therapy. CSS prognosis is generally not so poor, indicating the need to watch for possible reperforation in patients with complications of gastrointestinal perforation since steroid therapy does not improve angitis.

Key words
Churg-Strauss syndrome, gastrointestinal perforation, allergic granulomatous angitis

Reprint requests
Taro Oshikiri Second Department of Surgery, Hokkaido University Hospital N-14, W-5, Sapporo, 060-0814 JAPAN

Accepted
July 25, 2000

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