Seven cases of complete and incomplete forms of Churg-Strauss syndrome notrelated to leukotriene receptor antagonists

Background: Various forms of Churg-Strauss syndrome have been reported in a ssociation with the use of leukotriene receptor antagonists in asthmatic pa tients. Objective: Our purpose was to increase awareness that different for ms of the Churg-Strauss syndrome occur in patients not receiving leukotrien e modifiers. Methods: We searched for all the casts of Churg-Strauss syndro me that were seen in the University of Rochester Medical Center, New York, in the past 4 years. Results: We identified 7 patients, 6 of whom fulfilled the American College of Rheumatology criteria for the classification of Ch urg-Strauss syndrome, None of them used leukotriene receptor antagonists, A ll had asthma and sinus disease, The duration and severity of their asthma varied considerably; In the majority of the patients the features of Churg- Strauss syndrome became obvious as the systemic corticosteroid dose was bei ng tapered or discontinued, although 3 patients had not been receiving main tenance oral corticosteroids at disease onset, Three patients had positive antineutrophil cytoplasmic antibodies test result (perinuclear pattern). Th ere was histologic documentation of vasculitis in 4 patients, Five of 7 pat ients responded to high-dose corticosteroid treatment. Conclusion: Our 7 ca ses are similar to the various forms of Churg-Strauss syndrome that have be en reported in association with the leukotriene receptor antagonists. Compl ete or incomplete forms of this syndrome ran become apparent in asthmatic p atients as systemic corticosteroids are being tapered but ran also occur in patients with mild asthma of short duration who use only inhaled corticost eroids.