9)Churg-Strauss症候群

Churg-Strauss Syndrome

　Churg-Strauss症候群(アレルギー肉芽腫性血管炎)は，気管支喘息を主とするアレルギー性疾患の先行，好酸球増多，そして血管炎症候群を3主徴とする．血管炎による臨床所見として，消化管病変，多発性単神経炎，皮膚病変などがみられる．消化管病変は約半数で認め，胃，十二指腸，小腸，大腸に潰瘍，びらん，浮腫を呈する．潰瘍辺縁やびらんに強い発赤を認め，しばしば生検で好酸球浸潤を認める．また時に血管炎を確認できる．突然消化管穿孔を起こすことがあり，またその場合は死亡率が高い．このように，本症においては予後に影響しうる消化管病変にも留意すべきである．

　Churg-Strauss syndrome (allergic granulomatous angiitis) is clinically characterized by bronchial asthma, eosinophilia and vasculitis. Vasculitis syndrome includes gastrointestinal lesions, mononeuritis multiplex and skin lesions. Gastrointestinal involvement is observed in approximately 50％ of patients. Ulcer, erosion or edema are seen in the stomach, duodenum, small and large intestine. Marked erythema is frequently revealed in ulcer margins and erosions. Biopsy specimen demonstrates eosinophil infiltration and vasculitis. Because sudden gastrointestinal perforation increases the the risk of death, the possibility of gastrointestinal involvement of this syndrome should be considered.