Churg-Strauss syndrome (allergic granulomatous angiitis) with peculiar multiple colonic ulcers

We treated a 40-yr-old Japanese woman who had Churg-Strauss syndrome (CSS), as diagnosed by characteristic clinical features and histological findings; in addition, peculiar multiple colonic ulcers were seen during the course of her illness. Although gastrointestinal symptoms are often seen in CSS, there are few descriptions of lesions in the gastrointestinal tract. In the English literature, the gastrointestinal manifestations of CSS include eosinophilic gastroenteritis, but the mucosa is not usually ulcerated. On the other hand, Japanese cases are characterized by multiple ulcers which are considered to be caused by ischemia secondary to the vasculitis. Most of the reported cases have not been diagnosed until laparotomy or autopsy, and our case is the first with multiple ulcers throughout the entire colon as a complication of CSS.