Conjunctival involvement in Churg-Strauss syndrome

Area of Science:

• Ophthalmology
• Rheumatology
• Pulmonology

Background:

• Churg-Strauss syndrome, also known as eosinophilic granulomatosis with polyangiitis (EGPA), is a systemic vasculitis characterized by asthma, eosinophilia, and granulomatous inflammation.
• Ocular manifestations of EGPA are uncommon but can be severe, impacting visual prognosis.

Observation:

• A 64-year-old male presented with progressive conjunctival thickening in the right eye, preceding symptoms of an upper respiratory infection.
• Conjunctival biopsy revealed granulomatous inflammation with eosinophils, suggestive of EGPA.

Findings:

• The patient subsequently developed systemic symptoms including fever, dyspnea, renal failure, and anemia, confirming the diagnosis of EGPA.
• Treatment with systemic corticosteroids and cyclophosphamide resulted in complete resolution of both ocular and systemic disease.

Implications:

• This case highlights the importance of considering EGPA in patients with unexplained ocular and respiratory symptoms.
• Prompt diagnosis and aggressive immunosuppressive therapy are crucial for managing EGPA and preventing irreversible organ damage.
• Conjunctival biopsy can be a valuable diagnostic tool for EGPA.