Churg-Strauss syndrome (Allergic Angiitis and Granulomatosis)

A 25-year-old woman suffered from sinusitis, asthma and chronic cough intermittently for 1 year was admitted due to persistent worsening cough for 2-3 weeks. Her examination revealed a weakness in appearance and initial blood test results showed marked eosinophilia: WBC of 14100/cumm, neutrophil at 49%, lymphocyte at 13%, and eosinophil at 32%. Chest x–ray showed bilateral pulmonary nodules (Fig. 1) and computed tomography (CT) scan also demonstrated multiple peripheral pulmonary nodules, which suggested chronic eosinophil pneumonia (Fig. 2). However during hospitalization, her sputum TB, fungus, and bacteria cultures all showed no growth. In addition, sputum cytology, serum anti-nuclear antibody, antineutrophil cytoplasmic autoantibody and serum rheumatoid factor results were all negative. Bone marrow biopsy demonstrated eosinophilia and serum total eosinophil count increased up to 13030 /cumm. After treatment with prednisolone, she was discharged under the diagnosis of Churg-Strauss syndrome in a stable condition and her follow-up CT scan showed almost complete remission.