A severe form of Churg-Strauss syndrome complicated with acute cardiac failure and rapidly progressive peripheral neuropathy--a possible effect of intravenous immunoglobulin therapy

Intern Med. 2011;50(8):925-9. doi: 10.2169/internalmedicine.50.4648. Epub 2011 Apr 15.

Abstract

We report a case of Churg-Strauss syndrome (CSS) complicated by severe cardiac failure and peripheral neuropathy. Two courses of methylprednisolone pulse therapy were unable to control the disease activity. Repeated intravenous administration of high-dose human immunoglobulin (IVIg) was added together with intravenous cyclophosphamide pulse therapy (IVCY), and the patient's cardiac function and neurological symptoms were gradually ameliorated without any adverse event. Although glucocorticoid and cyclophosphamide comprise the standard therapy for patients with CSS, a number of patients with severe complications appear to be resistant to such conventional treatment. IVIg is thought to be an effective therapeutic option for such patients.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Churg-Strauss Syndrome / complications*
  • Churg-Strauss Syndrome / drug therapy
  • Churg-Strauss Syndrome / therapy*
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Disease Progression
  • Drug Therapy, Combination
  • Female
  • Heart Failure / etiology*
  • Heart Failure / therapy*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Methylprednisolone / administration & dosage
  • Middle Aged
  • Peripheral Nervous System Diseases / etiology*
  • Peripheral Nervous System Diseases / therapy*
  • Treatment Outcome

Substances

  • Immunoglobulins, Intravenous
  • Cyclophosphamide
  • Methylprednisolone