Inhaled corticosteroids and Churg-Strauss syndrome: a report of five cases

Churg-Strauss syndrome is an eosinophil-associated, small vessel granulomat ous vasculitis, characterized by late onset asthma, upper airways disease, eosinophilia, and clinical manifestations of systemic vasculitis, Several c ases of Churg-Strauss syndrome have been recognized in patients heated with cysteinyl leukotriene-receptor antagonists and weaned off systemic cortico steroids. These cases have led to a general warning on the possible develop ment of Churg-Strauss syndrome after taking cysteinyl leukotriene-receptor antagonists. The authors report five cases of Churg-Strauss syndrome in severe steroid d ependent asthmatics in whom inhaled corticosteroids allowed systemic cortic osteroid withdrawal. It is concluded that physicians should monitor patient s carefully when severe asthma is controlled with any substance allowing wi thdrawal from (or even avoidance) of systemic corticosteroids. Case-control studies should identify more precisely the risk factors of Chu rg-Strauss syndrome.