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Churg-Strauss Syndrome Presenting with Jejunal Perforations, Report of a Case Hideki Kondo 1 , Kunihiko Aoyagi 1 , Sin-ichiro Yada 1 , Kazuoki Hizawa 1 , Shotaro Nakamura 1,2 1The Second Department of Internal Medicine 2The Second Department of Pathology, Faculty of Medicine, Kyushu University, School of Medicine Keyword: Churg-Strauss症候群 , アレルギー性肉芽腫性血管炎 , 消化管穿孔 , 好酸球増多 pp.1257-1264
Published Date 1997/8/25
DOI https://doi.org/10.11477/mf.1403105041
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 A 62-year-old woman was admitted because of abdominal pain and gastrointestinal bleeding following corticosteroid therapy for asthma exacerbation in April 1994. She had a history of bronchial asthma at the age of 33 and liver cirrhosis at the age of 59. At the age of 60, she started to take corticosteroids to manage severe asthma. On admission, perforation of the jejunum was recognized and partial resection of the jejunum was performed. Multiple ulcers with three perforations were found in the resected specimen. Additionally, radiographic and endoscopic examinations revealed multiple shallow ulcers in the small bowel, colon and stomach. Histology of the resected small bowel specimen demonstrated vasculitis accompanying granulomatous change and eosinophil infiltration around the blood vessels. On the basis of clinical and histologic features, the patient was diagnosed as having Churg-Strauss syndrome. Treatment with 60 mg prednisolone daily was effective against her symptoms, eosinophilia and gastrointestinal multiple ulcers. Nevertheless, despite this good response, she developed liver injury which led to death. At autopsy, cicatrical vasculitis was found to involve the whole layer of arteries and veins in the stomach, small bowel, colon, liver and gallbladder, a condition indicative of Churg-Strauss syndrome.


Copyright © 1997, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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