PERİKARDİYAL EFFÜZYONLA SEYREDEN BİR CHURG STRAUSS SENDROMU OLGUSU

Yıl 2010, Cilt: 24 Sayı: 1, 49 - 54, 01.05.2010

Ömer Tamer Doğan Serdar Berk Gonca Özyol Öznur Abadoğlu Sefa Levent Özşahin Sulhattin Arslan İbrahim Akkurt

Öz

Churg-Strauss Sendromu (CSS); astım, eozinofili, küçük ve orta çaplı damarların inflamasyonu ile karakterize nadir görülen sistemik bir hastalıktır. Bu yazıda nefes darlığı, öksürük yakınmaları ile başvuran, astım, perikardiyal effüzyon ve eozinofili saptanan CSS olgusu sunulmuştur. 50 yaşında erkek hasta bir yıldır olan nefes darlığı, göğüs ağrısı, öksürük, balgam yakınması ile başvurdu. Hastanın solunum fonksiyon testlerinde orta derecede reversibl hava akımı obstr üksiyonu saptandı. Transtorasik ekokardiyografisinde perikardiyal effüzyon, periferik kanda ve bronş lavajında eozinofili saptandı. Akciğer grafisinde gezici infiltratlar izlendi. Bu bulgularla hastaya CSS tanısı kondu. Hastaya prednizolon tedavisi uygulandı. Tedavi ile belirgin klinik ve radyolojik iyileşme gözlendi.

Anahtar Kelimeler

Astım, eozinofili, vaskülit, perikardiyal effüzyon

A CASE OF CHURG-STRAUSS SYNDROME WITH PERICARDIAL EFFUSION

Öz

Churg-Strauss Syndrome (CSS) is a rare systemic disease characterized by asthma, eosinophilia and inflammation of small to medium sized blood vessels. This paper reports a patient who presented with dyspnea and cough, and who was diagnosed as asthma, pericardial effusion and eosinophilia. 50 year old male patient was admitted with dyspnea, chest pain, cough and sputum complaints for one year. Pulmonary function tests detected moderate reversible airflow obstruction. Transthoracic echocardiography revealed pericardial effusion. Eosinophilia was detected in both peripheric blood count and bronchial lavage. There were transient pulmonary infiltrates on chest X-ray. It was finally diagnosed as Churg-Strauss Syndrome with these findings. Corticosteroid therapy was performed. Clinical and radiological symptoms were improved with this treatment.

Anahtar Kelimeler

Asthma, eosinophilia, vasculitis, pericardial effusion

Kaynakça

• 1. Erdo¤an Bfi, Akta n fi, Çolako¤lu M, Bayramo¤lu H, Fiflekçi F. Churg-Strauss Sendromlu Bir Olgu. Türkderm 2002; 36: 132-5.
• 2. Pelà G, Tirabassi G, Pattoneri P, Pavone L, Garini G, Bruschi G. Cardiac involvement in the Churg-Strauss syndrome. Am J Cardiol, 2006; 97: 1519-24.
• 3. Tanoue LT. The eosinophilic pneumonias. In: Fishman AP. Fishmans’ Pulmonary Disease and Disorders. Nobel T›p Kitabevi 2005; 408-22.
• 4. Fraser RS, Colman N, Müller NL, Pare PD. Synopsis of Disease of the Chest. Ed: Haluk Türktafl (Çeviren) 1. Bask›, ‹stanbul, Günefl Kitabevi 2006; 481-524.
• 5. Çetinkaya E, fiafak G, Ürer N, Karasulu L, Sert S, Kalkan N, Alt›n S. Churg-Strauss Sendromu. Toraks Dergisi 2004; 5: 57-61.
• 6. Shikama N, Nakagawa T, Takiguchi Y, Aotsuka N, Kuwabara Y, Komiyama N, Terano T, Hirai A. Assesment of myocardial perfusion and fatty acid metabolism in a patient with Churg-Strauss Syndrome associated with eosinophilic heart disease. Circ J 2004; 68: 595-8.
• 7. Rosenberg M, Lorenz HM, Gassler N, Katus HA, Frey N. Rapid progressive eosinophilic cardiomyopathy in a patient with ChurgStrauss Syndrome. Clin Res Cardiol 2006; 95: 289-94.
• 8. Val-Bernal JF, Mayorga M, Garcia-Alberdi E, Pozueta JA. Churg-Strauss syndrome and sudden cardiac death. Cardiovasc Pathol 2003; 12: 94-7
• 9. Lynch III JP and Leatherman JW. Alveolar hemorrhage. In: Fishman’s pulmonary diseases and disorders. Third Edition Eds. Fishman AP, Elias JA, Fishman JA, Grippi MA, Kaiser LR, Senior RM. New York, McGraw-Hill 1998; 1193-210.
• 10. Masi AT, Hunder GG, Lie JT, Michel BA, Blonch DA, Arend WP, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lightfoot RW Jr, McShane DJ, Mills JA, Stevens MB, Wallace LS, Zvaifler NJ. The American College of Rheumatology 1990 criteria fort he classification of ChurgStrauss syndrome (Allergic granulomatosis and angiitis). Arthritis Rheum 1990; 33: 1094-100.
• 11. Çelik Y, K›z›latan G, Yald›ran A, Öz B. Bronflial Ast›m› Olan Bir Olguda Mononöritis Multilex Geliflimi: Churg-Strauss Sendromu. Cerrahpafla J Med 2000; 31: 113-7.
• 12. Agar C, Rendu E, Leguern V, Ponge T, Masseau A, Barrier JH, Trochu JN, Hamidou MA, Guillevin L. Churg-Strauss Syndrome revealed by granulomatous acute pericarditis: Two case reports and a rewiew of the literature. Seminars in Arthritis and Rheumatism 2007; 36: 386-91.