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Case Report
Delayed Relapse of Churg-Strauss Syndrome Manifesting as Colon Ulcers with Mucosal Granulomas: 3 Cases
NATHALIE MÉMAIN, MICHEL De BANDT, LOÏC GUILLEVIN, BERTRAND WECHSLER, and OLIVIER MEYER ABSTRACT. Churg-Strauss syndrome (CSS) is characterized by small vessel vasculitis and extravascular granulomas. The American College of Rheumatology classification criteria for CSS include asthma, eosinophilia, and clinical manifestation of vasculitis. Gastrointestinal (GI) manifestations occur in 30% of patients, but are inaugural in only 16%. They denote vasculitis of the stomach and small bowel wall, and consist in protean, nonspecific pain. GI involvement is of adverse prognostic significance in CSS. Ulcer formation in the GI tract mucosa is a rarer manifestation, usually discovered upon laparotomy or autopsy. We describe 3 new cases of colonic ulcers in CSS. Unusual features were diagnosis of the ulcers during a delayed relapse and presence of eosinophilic granulomas within the mucosa. (J Rheumatol 2002;29:388-91) Key Indexing Terms:
CHURG-STRAUSS SYNDROME
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