Document Detail

Churg-Strauss syndrome (CSS) manifested as necrosis of fingers and toes and liver infarction.
MedLine Citation:
PMID:  14684939     Owner:  NLM     Status:  MEDLINE    
We report a case of Churg-Strauss syndrome (CSS) with necrosis of the fingers and toes and liver infarction. A 59-year-old man with asthma suddenly noticed that his fingers and toes felt unusually cold. This condition worsened progressively, and some digits became necrotic within several weeks. Laboratory studies revealed hypereosinophilia and an extremely elevated serum level of IgE. Digital subtraction angiography of the extremities revealed extensive irregular narrowing of small and medium-sized arteries in the extremities. Abdominal computed tomography (CT) revealed an area of low density at the periphery of the right lobe of the liver. Angiography revealed irregular narrowing of small arteries that corresponded to the ischemic area. A nerve conduction study suggested sensory nerve neuropathy. The preceding asthma, acute onset of digital necrosis, liver infarction, neuropathy, and hypereosinophilia strongly suggested a diagnosis of CSS. The patient was treated with 40 mg of prednisolone and 120 micro g of intravenous prostaglandin E1 daily, and all the digits that had turned black and necrotic were amputated. After the amputation, the dose of prednisolone was gradually reduced, and no new lesions appeared on the skin or in the liver. The rare possible complications of CSS, including necrosis of digits and liver infarction, should not be ignored.
Yuichiro Otani; Saburo Anzai; Hiromi Shibuya; Sakuhei Fujiwara; Susumu Takayasu; Yuji Asada; Hiroto Terashi; Masahisa Takuma; Shigeo Yokoyama
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of dermatology     Volume:  30     ISSN:  0385-2407     ISO Abbreviation:  J. Dermatol.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-12-19     Completed Date:  2004-01-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7600545     Medline TA:  J Dermatol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  810-5     Citation Subset:  IM    
Department of Anatomy, Biology, and Medicine (Dermatology), Oita Medical University, Oita, Japan.
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MeSH Terms
Alprostadil / administration & dosage
Churg-Strauss Syndrome / complications,  diagnosis*,  pathology,  radiography,  therapy
Diagnosis, Differential
Fingers / pathology,  surgery
Infarction / etiology,  pathology,  radiography
Liver / blood supply
Liver Diseases / etiology*,  pathology,  radiography
Middle Aged
Prednisolone / administration & dosage
Toes / pathology,  surgery
Tomography, X-Ray Computed
Reg. No./Substance:
50-24-8/Prednisolone; 745-65-3/Alprostadil

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