Churg-Strauss syndrome: report of a case without preexisting asthma

A 38-year-old male with no history of asthma, who initially presented with episcleritis and subsequently developed symptoms of systemic vasculitis with marked blood eosinophilia, was diagnosed as having Churg-Strauss syndrome (CSS). Both the patient's skin lesions and pulmonary infiltrates revealed histologically proven vasculitis with predominantly eosinophilic infiltration. All the symptoms of systemic vasculitis except the persisting peripheral neuropathy dramatically improved after corticosteroid was systemically used. Since scattered non-asthmatic cases of CSS have been reported recently, and three such patients have died of acute heart failure due to delayed diagnosis, absence of asthma should not be regarded as an absolute criterion for exclusion of the diagnosis of CSS. Earlier recognition of this disease is important, since earlier institution of steroid therapy can prevent the acute onset of fatal cardiac involvement during the course of this disease.