Churg-Strauss Syndrome Presenting as Transverse Myelitis

Yong Won Cho; Hyukwon Chang; Jin Nyeong Chae; Sang-Hyon Kim

doi:10.4078/jkra.2009.16.4.328

Journal List > J Korean Rheum Assoc > v.16(4) > 1003694

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Cho, Chang, Chae, and Kim: Churg-Strauss Syndrome Presenting as Transverse Myelitis

Original Article

J Korean Rheum Assoc 2009;16(4):328-332.

Published online: 20 January 2009

DOI: https://doi.org/10.4078/jkra.2009.16.4.328

Churg-Strauss Syndrome Presenting as Transverse Myelitis

Yong Won Cho¹, Hyukwon Chang², Jin Nyeong Chae³, Sang-Hyon Kim³

¹Department of Neurology, School of Medicine, Keimyung University, Daegu, Korea

²Department of Radiology, School of Medicine, Keimyung University, Daegu, Korea

³Department of Internal Medicine, School of Medicine, Keimyung University, Daegu, Korea

Received 10 August 2009 Revised 20 August 2009 Accepted 9 September 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Churg-Strauss syndrome (CSS), also known as allergic granulomatous angiitis, is a rare disorder characterized by the presence of asthma, eosinophilia and small-to-medium-sized vessels vasculitis. The peripheral nervous system is frequently involved in CSS, but central nervous system (CNS) involvement is rare. Furthermore, transverse myelitis (TM) as a presenting symptom in patients with CSS is extremely rare. We report here on a 60-year-old female who presented peripheral eosinophilia, lung eosinophilic infiltration, lung vasculitis, and TM. She was diagnosed as CSS based on clinical manifestation, pathologic findings, and the use of magnetic resonance imaging (MRI).

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Keywords: Churg-Strauss syndrome, Transverse myelitis

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Fig. 1.

Lung setting computed tomography (CT) scan of the chest reveals a well defined nodule in the right upper lobe (0.7 cm in size, arrow).

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Fig. 2.

MRI findings. (A) Sagittal T2 weighted image (T2WI) of the T spine reveals diffuse swelling and increased signal intensity in T2–5 spinal cord (arrow), and focal increased signal intensity lesion in T6 spinal cord (arrowhead). (B) A four-month follow-up sagittal T2WI of the T spine reveals more resolution in the previous lesions, but there are focal residual signal intensity lesions in T4 and 6 spinal cord (arrow and arrowhead).

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Fig. 3.

Localized eosinophilic pneumonia (H&E, ×100, A) with perivascular eosinophilic infiltration in lung tissue (H&E, ×200, B).

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