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Short communication

Vol. 142 No. 1112 (2012)

Cardiac involvement in Churg-Strauss syndrome mimicking acute coronary syndrome

  • Fabio Rigamonti
  • Edoardo De Benedetti
  • Igor Letovanec
  • Antoine Rosset
  • Carlo Chizzolini
Cite this as:
Swiss Med Wkly. 2012;142:w13543
Published
11.03.2012

Summary

Churg-Strauss syndrome (CSS) is a rare multisystemic disorder of unknown origin and cardiac involvement is one of the most serious manifestations of the disease, accounting for approximately one-half of deaths attributable to CSS. Cardiac manifestation can be acute and mimic acute coronary syndrome (ACS). In this setting checking the blood leucocyte count can reveal hypereosinophilia and lead to a diagnosis of CSS.

References

  1. 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. 1990;33:1094.
  2. Lanham JG, Elkon KB, Pusey CD, Hughes GR. Systemic vasculitis with asthma and eosinophilia: A clinical approach to the Churg-Strauss syndrome. Medicine. 1984;63:65.
  3. Noth I, Strek ME, LeV AR. Churg-Strauss syndrome. Lancet. 2003;361:587–94.
  4. Della Rossa A, Baldini C, Tavoni A, et al. Churg-Strauss syndrome: clinical and serological features of 19 patients from a single Italian centre. Rheumatology. (Oxford) 2002;41:1286.
  5. Sable-Fourtassou R, Cohen P, Mahr A, et al. Antineutrophil cytoplasmic antibodies and the Churg-Strauss syndrome. Ann Intern Med. 2005;143:632.
  6. Neumann T, Manger B, Schmid M, et al. Cardiac involvement in Churg-Strauss syndrome: impact of endomyocarditis. Medicine. (Baltimore) 2009;88:236.
  7. Corradi D, Maestri R, Facchetti F. Post-partum Churg-Strauss syndrome with severe cardiac involvement: description of a case and review of the literature. Clin Rheumatol. 2009;28:739.
  8. Ogbogu PU, Rosing DR, Horne MK, 3rd. Cardiovascular manifestations of hypereosinophilic syndromes. Immunol Allergy Clin North Am. 2007;27:457.
  9. Weller PF, Bubley GJ. The idiopathic hypereosinophilic syndrome. Blood. 1994;83:2759.
  10. Hirakawa Y, Koyanagi S, Matsumoto T, Takeshita A, Nakamura M. A case of variant angina associated with eosinophilia. Am J Med. 1989;87:472–4.
  11. Hertzman PA, Maddoux GL, Stenberg EM, Heyes MP, Mefford IN, Kephart GM, et al. Repeated coronary artery spasm in a young woman with the eosinophilia-myalgia syndrome. JAMA. 1992;267:1932–34.
  12. Naohiko Takahashi, Katsuhiro Kondo, Juntaro Aoyagi. Acute myocardial infarction associated with hypereosinophilic syndrome in a young man. Jpn Circ J. 1997;61:803–6.
  13. Mavrogeni S, Manoussakis MN, Karagiorgia TC, et al. Detection of coronary artery lesions and myocardial necrosis by magnetic resonance in systemic necrotizing vasculitides. Arthritis Rheum. 2009;61:1121.
  14. De Cobelli F, Pieroni M, Esposito A, Chimenti C, et al. Delayed gadolinium-enhanced cardiac magnetic resonance inpatients with chronic myocarditis presenting with heart failure or recurrent arrhythmias. J Am Coll Cardiol. 2006;47(8):1649–54.
  15. Jen Li Looi, Peter Ruygrok, Gordon Royle, et al. Acute eosinophilic endomyocarditis: early diagnosis and localization of the lesion by cardiac magnetic resonance imaging. Int J Cardiovasc Imaging. 2010;26:151–4.
  16. Alter P, Maisch B. Endomyocardial fibrosis in Churg-Strauss syndrome assessed by cardiac magnetic resonance imaging. Int J Cardiol. 2006;108:112–3.
  17. Hans-Uwe Simon, et al. Refining the definition of hypereosinophilic syndrome. J. Allergy Clin Immunol. Vol.126,1:45–9.
  18. Vassina EM, Yousefi S, Simon D, Zwicky C, Conus S, Simon HU. cIAP2 and surviving contribute to cytokine-mediated delayed eosinophil apoptosis. Eur J Immunol. 2006;36:1975–84.
  19. Klion AD, Noel P, Akin C, et al. Elevated serum tryptase levels identify a subset of patients with a myeloproliferative variant of idiopathic hypereosinophilic syndrome associated with tissue fibrosis, poor prognosis and imatinib responsiveness. Blood. 2003;101:4660.
  20. Desreumaux P, Janin A, Dubucquoi S, et al. Synthesis of interleukin-5 by activated eosinophils in patients with eosinophilic heart diseases. Blood. 1993;82:1553–60.
  21. Pagnoux C, Guillevin L. Churg-Strauss syndrome: evidence for disease subtypes? Curr Opin Rheumatol. 2010;22:21.
  22. Guillevin L, Lhote F, Gayraud M, Cohen P, Jarrousse B, Lortholary O, et al. Prognostic factors in polyarteritis nodosa and Churg-Strauss syndrome. A prospective study in 342 patients. Medicine (Baltimore). 1996;75:17–28.
  23. Pitini V, Arrigo C, Azzarello D, La Gattuta G, Amata C, Righi M, et al. Serum concentration of cardiac Troponin T in patients with hypereosinophilic syndrome treated with imatinib is predictive of adverse outcomes. Blood. 2003;102:3456.
  24. Zaky J, Caraang C, Yu R, El-Bialy A. Elevated troponins and the Churg-Strauss syndrome: a case report. J Cardiovasc Pharmacol Ther. 2005;10:131.
  25. Sato Y, Taniguchi R, Yamada T, et al. Measurements of serum concentrations of cardiac troponin T in patients with hypereosinophilic syndrome: a sensitive non-invasive marker of cardiac disorder. Intern Med. 2000;39(4):350.