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Churg-Strauss syndrome in children: a clinical and pathologic review
Debra Boyer1, Sara O Vargas, Dubhfeasa Slattery
1Department of Medicine, Division of Respiratory Diseases, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02155, USA. debra.boyer@childrens.harvard.edu
Insights
Churg-Strauss syndrome, a rare vasculitis, can affect children, presenting with severe asthma and lung issues. This report highlights two pediatric cases to increase awareness of this serious condition in younger populations.
Area of Science:
- Pediatric Rheumatology
- Pulmonology
- Immunology
Background:
- Churg-Strauss syndrome (CSS), a form of vasculitis, is typically diagnosed in adults.
- CSS is characterized by asthma, eosinophilia, and systemic inflammation.
- Pediatric CSS cases are infrequently reported, limiting understanding of its presentation in children.
Observation:
- Two pediatric patients presented with severe pulmonary involvement suggestive of CSS.
- One patient, aged 16, experienced pleuritic chest pain, pulmonary nodules, and eosinophilic pleural effusion.
- A second patient, aged 6, exhibited cough, weight loss, and radiographic infiltrates.
Findings:
- Lung biopsies confirmed characteristic CSS findings, including eosinophilic microabscesses and vasculitis.
- Both patients showed persistent symptoms over 3-5 years despite medical management.
- The cases illustrate typical CSS features in a pediatric context.
Implications:
- These cases expand the limited knowledge of pediatric Churg-Strauss syndrome.
- Heightened awareness is crucial for early diagnosis and management of CSS in children.
- Further research into pediatric CSS is warranted to improve treatment strategies.
Abstract:
Churg-Strauss syndrome is a vasculitis accompanied by asthma and eosinophilia. It is generally considered a disease of adults; occurrence in children has been reported infrequently. Here we report 2 pediatric patients with Churg-Strauss syndrome manifesting with prominent pulmonary involvement. One, a 16-year-old with a previous history of asthma, presented with pleuritic chest pain and a peripheral pulmonary nodule complicated by an eosinophilic pleural effusion. The other patient presented at age 6 with cough, weight loss, and radiographic infiltrates. Lung biopsies revealed elements characteristic of Churg-Strauss syndrome, including eosinophilic microabscesses and vasculitis. Three- and 5-year follow-up showed continued symptoms in both patients despite medical therapy. Both patients illustrate many of the typical features of Churg-Strauss syndrome. We report these cases to expand the scant knowledge about Churg-Strauss syndrome in pediatric patients and to heighten awareness that this serious disease may affect the pediatric population. The relevant literature on Churg-Strauss syndrome, with specific reference to childhood cases, is reviewed.
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