Document Detail


Treatment for Churg-Strauss syndrome: induction of remission and efficacy of intravenous immunoglobulin therapy.
MedLine Citation:
PMID:  17460439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Churg-Strauss syndrome (CSS) is characterized by the presence of asthma, eosinophilia, and small-vessel vasculitis with granuloma. It is a distinct entity, as determined from all classifications of systemic vasculitis. The poor prognostic factors in CSS are renal insufficiency, cardiomyopathy, severe gastrointestinal (GI) tract, and central nervous systems (CNS) involvement. The initial management of CSS should include a high dose of a corticosteroid: prednisone at 1 mg/kg/day or its equivalent for methylprednisolone with tapering over 6 months. In patients with severe or rapidly progressing CSS, the administration of methylprednisolone pulse at 1 g/body/day for 3 days is recommended. When corticosteroid therapy does not induce remission, or when patients have poor prognostic factors, immunosuppressive cytotoxic therapy is indicated. However, some patients with severe CSS often show resistance to conventional treatment. We think that IVIG therapy is a hopeful candidate for second-line treatment for CSS patients, particularly in the case of neuropathy and/or cardiomyopathy, which are resistant to conventional therapy. However, there is not much evidence supporting the effectiveness of IVIG in CSS, and the mechanisms underlying the action of IVIG remain unclear. Now we are performing clinical trials of IVIG therapy for CSS patients who are resistant to conventional treatment, through a nationwide double-blinded placebo-controlled study in Japan.
Authors:
Masami Taniguchi; Naomi Tsurikisawa; Noritaka Higashi; Hiroshi Saito; Haruhisa Mita; Akio Mori; Hiroki Sakakibara; Kazuo Akiyama
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Publication Detail:
Type:  Journal Article; Review     Date:  2007-05-01
Journal Detail:
Title:  Allergology international : official journal of the Japanese Society of Allergology     Volume:  56     ISSN:  1323-8930     ISO Abbreviation:  Allergol Int     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-29     Completed Date:  2007-08-09     Revised Date:  2008-03-06    
Medline Journal Info:
Nlm Unique ID:  9616296     Medline TA:  Allergol Int     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  97-103     Citation Subset:  IM    
Affiliation:
National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan. m-taniguchi@sagamihara-hosp.gr.jp
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Antibodies, Monoclonal / therapeutic use
Biological Markers / urine
Churg-Strauss Syndrome / drug therapy*,  immunology,  urine
Cyclophosphamide / therapeutic use
Humans
Immunoglobulins, Intravenous / therapeutic use*
Immunologic Factors / therapeutic use*
Immunosuppressive Agents / therapeutic use
Interferon-alpha / therapeutic use
Leukotriene E4 / urine
Methylprednisolone / therapeutic use
Plasma Exchange
Prednisolone / therapeutic use
Remission Induction
Salvage Therapy*
Treatment Failure
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Antibodies, Monoclonal; 0/Biological Markers; 0/Immunoglobulins, Intravenous; 0/Immunologic Factors; 0/Immunosuppressive Agents; 0/Interferon-alpha; 50-18-0/Cyclophosphamide; 50-24-8/Prednisolone; 75715-89-8/Leukotriene E4; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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