[Stroke as a predominant symptom at Churg-Strauss syndrome]

Intracerebral hemorrhage is a rare sequel of Churg-Strauss syndrome. We report a case of 55 years old man, who was admitted to the National Tuberculosis and Lung Diseases Research Institute because of paroxysmal dyspnea and persistent cough. 6 months prior to hospitalization the patient suffered from spontaneous intracerebral hemorrhage. The laboratory studies revealed: leukocytosis with 65% being eosinophils, elevated serum IgE (810 IU/ml) and pANCA titre (1:640). HRCT disclosed in both lungs several small ground glass attenuations and thickening of bronchial walls. In bronchoalveolar lavage numerous eosinophils were noted. During hospitalization episodes of dyspnea with bronchospasm improving after beta2-mimetics inhalation were repeatedly observed, the findings that could suggest asthma. Based on clinical criteria of French Vasculitis Study Group, Churg-Strauss syndrome was recognized. The patient was treated with prednisone 50 mg daily with rapid regression of the respiratory symptoms and gradual normalization of the laboratory results.