Abstract
Churg–Strauss syndrome (CSS) is a rare, systemic, necrotizing, small- and middle-sized vessel vasculitis which is accompanied by blood eosinophilia, eosinophil infiltration of various tissues, and bronchial asthma. The lungs are the organs most often involved in CSS. The aim of this study was a retrospective evaluation of the pulmonary findings in chest X-rays and high resolution computed tomography (HRCT) in CSS patients at the time of initial diagnosis and to determine their frequency, character, and location. Seventeen CSS patients were studied (12 women; 5 men; aged 29–56 years). In all patients at the time of initial diagnosis, chest X-rays were performed, and in 15 patients, HRCT was performed additionally. The radiological images were evaluated independently by two radiologists who reached a decision by consensus. Out of 17 patients studied, chest X-rays revealed parenchymal abnormalities in 11, pleural effusion in three, and bronchial wall thickening in one. In five patients, no abnormalities in chest X-rays were found. In HRCT, abnormalities were found in all patients (15 patients, 100%). Predominant HRCT findings consisted of: ground-glass opacities and consolidations found in 13 patients (86.7%). Additionally, in four patients, pulmonary micronodules were described; in ten, interlobular septal thickening; in three, linear opacities; in ten, bronchial wall thickening and/or bronchial dilatation; and in three, pleural effusions. Ground-glass opacities and consolidation abnormalities distribution pattern were peripheral in seven and random in six patients. In patients with CSS, the most common pulmonary radiological findings are parenchymal opacities, which may be peripheral or random in distribution. Pathologic changes were found in 70.6% of patient in chest X-rays, and in 100%, when HRCT was performed. These changes are nonspecific; however, they should be not overlooked, as they may help in establishing the diagnosis and suggest the prognosis.
Similar content being viewed by others
References
Churg J, Strauss L (1951) Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am J Pathol 27(2):277–301
Pagnoux C, Guilpain P, Guillevin L (2007) Churg-Strauss syndrome. Curr Opin Rheumatol 19(1):25–32
Noth I, Strek ME, Leff AR (2003) Churg-Strauss syndrome. Lancet 361(9357):587–594
Abril A, Calamia KT, Cohen MD (2003) The Churg Strauss syndrome (allergic granulomatous angiitis): review and update. Semin Arthritis Rheum 33(2):106–114
Masi AT et al (1990) The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 33(8):1094–1100
Chumbley LC, Harrison EG Jr, DeRemee RA (1977) Allergic granulomatosis and angiitis (Churg-Strauss syndrome). Report and analysis of 30 cases. Mayo Clin Proc 52(8):477–484
Worthy SA et al (1998) Churg-Strauss syndrome: the spectrum of pulmonary CT findings in 17 patients. AJR Am J Roentgenol 170(2):297–300
Choi YH et al (2000) Thoracic manifestation of Churg-Strauss syndrome: radiologic and clinical findings. Chest 117(1):117–124
Kim YK et al (2007) Pulmonary involvement in Churg-Strauss syndrome: an analysis of CT, clinical, and pathologic findings. Eur Radiol 17(12):3157–3165
Silva CI et al (2005) Churg-Strauss syndrome: high resolution CT and pathologic findings. J Thorac Imaging 20(2):74–80
Furuiye M et al (2010) Churg-Strauss syndrome versus chronic eosinophilic pneumonia on high-resolution computed tomographic findings. J Comput Assist Tomogr 34(1):19–22
Luqmani RA et al (1994) Birmingham Vasculitis Activity Score (BVAS) in systemic necrotizing vasculitis. QJM 87(11):671–678
Bateman ED et al (2008) Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 31(1):143–178
Austin JH et al (1996) Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society. Radiology 200(2):327–331
Szczeklik W et al (2010) Lung involvement in Churg-Strauss syndrome as related to the activity of the disease. Allergy
Lanham JG et al (1984) Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome. Medicine (Baltimore) 63(2):65–81
Ando Y et al (2004) Thoracic manifestation of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-related disease. CT findings in 51 patients. J Comput Assist Tomogr 28(5):710–716
Silva CI, Colby TV, Muller NL (2004) Asthma and associated conditions: high-resolution CT and pathologic findings. AJR Am J Roentgenol 183(3):817–824
Disclosures
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Szczeklik, W., Sokołowska, B., Mastalerz, L. et al. Pulmonary findings in Churg–Strauss syndrome in chest X-rays and high resolution computed tomography at the time of initial diagnosis. Clin Rheumatol 29, 1127–1134 (2010). https://doi.org/10.1007/s10067-010-1530-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-010-1530-3