DRUG-RELATED CHURG-STRAUSS-SYNDROME

Churg-Strauss syndrome (CSS) is a rare disease belonging to the group of necrotizing vasculitides affecting medium and small vessels, classi fied together with Wegener granulomatosis and microscopic polyarteriti s. The literature is reviewed concerning vasculitides associated with drug use, focusing on CSS. A representative case of CSS is reported, i n whom the possibility could not be excluded that oestrogen replacemen t therapy contributed to the onset of CSS. The case of a 56-year-old f emale patient is presented who had a history of allergic rhinitis and steroid-dependent asthma for years. To prevent postmenopausal complain ts and further loss of bone density, she received oestrogen replacemen t therapy. After three months of hormone therapy, signs of CSS appeare d. Oestrogen administration (1 mg norethisterone acetate, 1 mg oestrio l and 2 mg oestradiol daily) was stopped. The diagnosis was confirmed by the clinical appearance, laboratory tests and tissue biopsies. The patient received corticosteroids and cyclophosphamide treatment and su bsequently the eosinophil count returned to normal within two weeks an d her condition improved significantly.