Cholinesterase deficiency and the Churg-Strauss syndrome

We report two patients with the Churg-Strauss syndrome who were found to have decreased cholinesterase activity despite normal phenotypes. Suspicion of abnormal sensitivity to suxamethonium in the first case was raised after prolonged paralysis under anaesthesia. The findings in the second were incidental during the course of intensive care treatment. Both patients received immunosuppressive therapy. Differentiation between the effects of this and the disease process itself cannot be established.