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Renal involvement in Churg-Strauss syndrome.

Renato Alberto Sinico1, Lucafrancesco Di Toma, Umberto Maggiore

  • 1Dipartimento Area Medica, Azienda Ospedaliera Ospedale San Carlo Borromeo, Milan, Italy. renato.sinico@oscb.sined.net

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|April 25, 2006
PubMed
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Renal abnormalities affect about a quarter of patients with Churg-Strauss syndrome (CSS). The most common kidney issue is ANCA-associated necrotizing crescentic glomerulonephritis, but other forms can occur, with generally good outcomes.

Area of Science:

  • Nephrology
  • Rheumatology
  • Internal Medicine

Background:

  • Churg-Strauss syndrome (CSS) is a rare condition involving asthma, eosinophilia, and systemic vasculitis.
  • Renal involvement is often underestimated, with variable prevalence and severity reported in small patient series.

Purpose of the Study:

  • To investigate the prevalence, clinicopathologic features, and prognosis of renal disease in patients with CSS.
  • To characterize the spectrum of kidney involvement and its impact on patient outcomes.

Main Methods:

  • Retrospective analysis of 116 patients diagnosed with CSS.
  • Assessment of renal abnormalities, including laboratory tests, urinalysis, and renal biopsies.
  • Correlation of renal disease with antineutrophil cytoplasmic antibody (ANCA) status and patient prognosis.

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Main Results:

  • Renal abnormalities were identified in 26.7% of CSS patients.
  • Necrotizing crescentic glomerulonephritis, often ANCA-positive, was the predominant biopsy finding.
  • While some patients experienced renal insufficiency, overall long-term outcomes and mortality were generally favorable.

Conclusions:

  • Renal involvement is a significant feature in approximately one-quarter of CSS patients.
  • ANCA-associated necrotizing crescentic glomerulonephritis is the most frequent nephropathy, though other renal pathologies can be present.
  • Despite potential for renal impairment, the prognosis for CSS patients with renal involvement is typically good with appropriate management.