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Churg-Strauss presenting as acute coronary syndrome: sometimes it's zebras

Nicholaos Kakouros1, Rachel Bastiaenen, Antonios Kourliouros

  • 1Department of Cardiology, Johns Hopkins School of medicine, Baltimore, Maryland, USA. nkakouros@gmail.com

BMJ Case Reports
|June 16, 2012
PubMed

Insights

A rare vasculitis, Churg-Strauss syndrome, can present with severe, seemingly unrelated symptoms like chest pain and vision loss. Early diagnosis and immunosuppressant treatment are crucial for successful outcomes in these complex cases.

Area of Science:

  • Cardiology
  • Rheumatology
  • Neurology

Background:

  • Churg-Strauss syndrome, also known as eosinophilic granulomatosis with polyangiitis, is a rare systemic vasculitis.
  • It is characterized by asthma, hypereosinophilia, and systemic eosinophilic granulomatous disease.

Observation:

  • A 53-year-old male presented with troponin-positive chest pain, peripheral edema, and prior visual disturbances and fever.
  • Physical examination revealed mononeuritis and a vasculitic rash.
  • Laboratory findings included marked hypereosinophilia and elevated immunoglobulin E (IgE).

Findings:

  • The patient's presentation mimicked acute coronary syndrome and occult infection.
  • A unifying diagnosis of Churg-Strauss syndrome was established based on clinical and laboratory findings.
  • The patient responded successfully to immunosuppressant therapy.

Implications:

  • This case highlights a fulminant presentation of Churg-Strauss syndrome.
  • It underscores the importance of considering rare systemic vasculitides in patients with multisystem involvement.
  • Prompt diagnosis and treatment with immunosuppressants are vital for managing this condition.

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