Churg-Strauss症候群の再燃を来した気管支喘息症例

入院中にChurg-Strauss症候群の再燃を来した症例を報告した｡症例は気管支喘息を有する73歳の女性で,持続する両下肢の知覚障害を主訴に当院に入院した｡入院2週頃より微熱,下腹部不快感が続き右下肢のdrop foot,下血を呈した｡末梢血では著明な好酸球増多を認め,内視鏡検査で直腸潰瘍を認めた。3年前の両下肢の知覚障害出現時にも同様の症状を経験しており,Churg-Strauss症候群の再燃と診断し,ステロイド治療を開始することにより新たな後遺症を残すことなく寛解に至った｡Churg-Strauss症候群の発症･再燃の機序を考える上で貴重な症例と考え,文献的考察を加え報告する｡

A recurrent case of Churg-Strauss syndrome (CSS) associated with bronchial asthma is reported. A 73-year-old woman with bronchial asthma was admitted to our hospital because of persistent sensory disturbance of the bilateral lower limbs. About 2 weeks or more after admission, slight fever and an unpleasant sensation in the lower abdomen appeared and continued. Several days later, drop foot and melena developed. The eosinophil count was markedly increased and the endoscopic examination revealed rectal ulcers. Since the patient had a same experience of these symptoms three years ago, the recurrence of CSS was strongly suggested. Immediately after steroid treatment was started, these newly developed symptoms were relieved with no segulae. We reported the present case, which may be useful for clarifying the onset of CSS, with a review of the literature.