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Abstract

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Article in Japanese

Case Report

A case of Churg-Strauss syndrome with subarachnoid hemorrhage and left phrenic nerve paralysis

Kyoko Shimizu  Hiromi Ohoba  Hiroyuki Shimada  Yukihisa Inoue  Yasuto Jinn  Nobuyuki Yoshimura 

Department of Respiratory Medicine, Hiratsuka Kyosai Hospital

ABSTRACT

A 60-year-old woman was given a diagnosis of Churg-Strauss syndrome (CSS) in 2000 because of peripheral blood eosinophilia, eosinophilic pneumonia, asthma, polyarticular pain, and limb numbness. She was treated with prednisolone (PSL), and the above symptoms improved but then relapsed on tapering of PSL. In September 2009, after 7 days of tapering of PSL to 5 mg/day, the patient developed a subarachnoid hemorrhage and was admitted. MRA and cerebral angiography revealed no aneurysm; the source of bleeding could not be determined, but her symptoms indicated a benign course. A chest X-ray 27 days after admission showed left diaphragmatic elevation, and left phrenic nerve paralysis was diagnosed by a phrenic nerve stimulation test. Peripheral blood eosinophilia had progressed gradually during the admission period, and although it is rare for subarachnoid hemorrhage and phrenic nerve paralysis to be associated with CSS, we regarded these as vasculitis symptoms related to CSS.

KEYWORDS

Churg-Strauss syndrome  Subarachnoid hemorrhage  Phrenic nerve paralysis  Eosinophilia 

Received 平成22年8月30日

JJRS, 49(9): 642-646, 2011

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