The Journal of the Japanese Respiratory Society ONLINE JOURNAL

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Article in Japanese

Case Report

A case of Churg-Strauss syndrome with methylprednisolone sodium succinate allergy

Taro Yoneda, Nobuyuki Katayama, Hideharu Kimura and Masaki Fujimura

Department of Respiratory Medicine, Kanazawa University Hospital

ABSTRACT

A 63-year-old man with a history of therapy for asthma was admitted to a neighborhood hospital for treatment of a lower limb blister, accompanied by edema, pain and systemic fever. Churg-Strauss syndrome was diagnosed based on an increase in peripheral blood eosinophils, positive MPO-ANCA and other findings. He was given an injection of methylprednisolone sodium succinate; however his lower limb pain, fever and peripheral blood eosinophilia worsened. Therefore, steroid-resistant Churg-Strauss syndrome was diagnosed, for which he was referred to our hospital for more intensive treatment. His lower limb pain, fever, peripheral blood eosinophilia and inflammatory reactions improved immediately after switching treatment to oral prednisolone. Since a challenge test using an intravenous infusion of methylprednisolone sodium succinate worsened the lower limb pain, fever and peripheral blood eosinophilia, a drug allergy was diagnosed together with Churg-Strauss syndrome.

KEYWORDS: Churg-Strauss syndrome, Succinic acid, Steroid, Drug allergy

RECEIVED: 2009.5.20

JJRS, 47(12): 1147-1150, 2009