Churg-Strauss Syndrome

Churg-Strauss syndrome also known as eosinophilic granulomatosis with polyangiitis, is a disorder characterized by blood vessel inflammation. It is one of the many forms of vasculitis, which restricts blood flow to vital organs and tissues, causing permanent damage in some cases.

Asthma is the most common sign of Churg-Strauss syndrome, but it can also cause a variety of problems, ranging from hay fever, rash and gastrointestinal bleeding to extreme pain and numbness in hands and feet. The vast array of signs and symptoms exhibits similarity to other disorders, making Churg-Strauss syndrome difficult to diagnose.

Though Churg-Strauss syndrome does not have definite cure, doctor can help the patient to deal with symptoms with the use of steroids and other potent immunosuppressant drugs.

The exact cause of Churg-Strauss syndrome is unknown.

It may be possibly formed as a reaction to an overactive immune system triggered by a combination of genes or due to allergens or certain medications. Instead of offering protecting from invading organisms such as bacteria and viruses, the immune system overreacts and targets healthy tissues, causing widespread inflammation.

An asthma and allergy medication called montelukast has been found to cause Churg-Strauss syndrome. Also, switching from low-dose oral systemic steroids to inhaled steroid medications causes the same.

Churg-Strauss syndrome causes fever, weight loss, and sinus or nasal passage inflammation in asthmatic patient. Fatigue is common. Symptoms such as cough, shortness of breath, and chest pain are found to occur as the lungs are affected by vasculitis.

Skin lumps, called nodules are observed. Diarrhea and pain in the belly arises from inflammation in blood vessels of abdomen. The bladder and prostate gland get inflamed. Numbness or weakness resulting from nerve injury is seen. When brain is affected, seizures or confusion can also occur. Most people with Churg-Strauss syndrome have a type of nerve damage called peripheral neuropathy, which causes numbness or pain in your hands and feet.

Churg-Strauss syndrome may be confirmed on the basis of above symptoms or a history of asthma. Abnormalities of the lungs, skin, and nerves are found by the doctor during examination. An elevation in Blood pressure is also observed.

Blood examination usually shows increased levels of an uncommon white blood cell called as eosinophil. It also helps to find autoantibodies, a type of protein formed by body as response to immune attack. Abnormal urinalysis and kidney function blood tests are observed in rare cases.

When the lungs are inflamed, chest x-ray image or CT scan of chest can determine areas of inflammation. Sinus problems are observed. Migratory spots or lesions mimicking pneumonia are found on a chest X-ray. Imaging tests comprising of X-rays, computerized tomography (CT) scans and magnetic resonance imaging (MRI) search for abnormalities in lungs and sinuses.

The important test for the diagnosis is a biopsy of involved tissue, which can rule out or confirm vasculitis.

The treatment of Churg-Strauss syndrome patients is aimed at lowering the inflammation of the blood vessels (vasculitis) and suppressing the immune system. Treatment usually includes high doses of cortisone-related medication (such as prednisone or prednisolone) to reduce the inflammation and use of cyclophosphamide (Cytoxan) to suppress the active immune system.

Generally, cyclophosphamide is given for a year or more in patients with Churg-Strauss syndrome. In a research study, Churg-Strauss syndrome patients benefit from cyclophosphamide over the course of 6-12 months.

Lifestyle Remedies
While taking cortisone, it is important to take adequate amounts of calcium and vitamin D to prevent bone loss and possible fractures. Daily vitamin D and calcium can be included as supplements or in diet. Maintaining a healthy weight is also important while taking corticosteroid medications. Strength training and weight-bearing exercises such as walking and jogging also benefit bone health.

It is advisable to quit smoking while taking medications. A healthy diet rich in foods such as fruits, vegetables and whole grains that regulate blood sugar are helpful. Refrain from using steroids which can cause high blood sugar levels and also type 2 diabetes.

Homeopathic Treatment
A specified medicine for Churg-Strauss syndrome does not yet exist. However, asthma can be effectively treated with dosage of homeopathic medicines. Remedies include Arsenicum Album, Ipecac, Lachesis, Pulsatilla, Spongia, Sulfur, Ignatia, Hepar-Sulph, Natrum Sulph, Tuberculinum etc. Consult homeopathic physician before proceeding with self-prescription.

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2. Churg J, Strauss L. Allergic granulomatosis, allergic angiitis, and periarteritis nodosa.Am J Pathol. Mar-Apr 1951;27(2):277-301.

3. Churg A. Pulmonary angiitis and granulomatosis revisited.Hum Pathol. Oct 1983;14(10):868-83.

4. Keogh KA, Specks U. Churg-Strauss syndrome: clinical presentation, antineutrophil cytoplasmic antibodies, and leukotriene receptor antagonists.Am J Med. Sep 2003;115(4):284-90.

5. Masi AT, Hunder GG, Lie JT, et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis).Arthritis Rheum. Aug 1990;33(8):1094-100.

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