Churg-Strauss syndrome with renal involvement: a case report

Area of Science:

• Nephrology
• Rheumatology
• Immunology

Background:

• Churg-Strauss syndrome (CSS), also known as eosinophilic granulomatosis with polyangiitis (EGPA), is a rare systemic vasculitis characterized by asthma, eosinophilia, and granulomatous inflammation.
• Renal involvement in CSS is often underrecognized, with varying degrees of kidney damage reported.

Observation:

• A 51-year-old woman presented with abdominal pain, diarrhea, and purpura, indicative of systemic vasculitis.
• Diagnostic criteria for CSS were met, including asthma history, marked eosinophilia, elevated IgE levels, and characteristic skin biopsy findings.
• Initial assessment revealed impaired renal function (creatinine clearance 43.3 ml/min) with proteinuria and microscopic hematuria.

Findings:

• The patient's renal abnormalities, including proteinuria and hematuria, demonstrated significant improvement following systemic corticosteroid therapy.
• Histopathological examination of the purpuric lesions confirmed eosinophilic infiltration and vasculitis, consistent with CSS.
• The case highlights the potential for significant renal dysfunction in CSS patients.

Implications:

• This case suggests that renal involvement may be a more frequent manifestation of Churg-Strauss syndrome than previously appreciated.
• Early recognition and prompt treatment with corticosteroids are crucial for managing renal complications in CSS.
• Further research is warranted to elucidate the prevalence and long-term renal outcomes in patients with CSS.