Abstract: The Churg-Strauss syndrome is a small vessel vasculitis associated
with asthma and eosinophilia. It can sometimes present in unusual ways such as
mononeuritis multiplex or subarachnoid hemorrhage. The various symptoms and
signs are discussed, such as fever, skin lesions and allergic rhinitis. The
sudden onset of blindness and deafness can occur. Cardiac involvement is
common, but central nervous system lesions are rare. The diagnosis of the
syndrome is based on clinical findings such as asthma, eosinophilia,
neuropathy, and sinusitis, and it can certainly mimic conditions such as the
Guillain-Barré syndrome. The cause of the syndrome is uncertain, but
studies have suggested that it may well be an autoimmune disease. However, an
allergy may be only one of several mechanisms triggering symptoms. There seems
to be no doubt that certain drugs, notably leukotriene-receptor antagonists,
can be to blame, and so can eotoxin-3. Symptoms can respond to treatment with
immunosupressive drugs, and since their introduction, the survival rate has
been markedly increased. Trials with other drugs, such as rituximab and
omalizumab are reported. In cases of intractable asthma, the diagnosis of this
syndrome should be considered.
