[Successful treatment with lobenzarit disodium in case of Churg-Strauss syndrome]

In this case the patient was a 62-year-old male with a chief complain of sensory disturbance of the extremities. In January 1987 he was diagnosed as having bronchial asthma by a neighboring doctor and began to receive prednisolone (PSL) therapy at his hospital on an ambulatory basis. Later on, in January 1990, he developed dyspnea, epigastralgia, ecchymoses and muscle weakness of the lower extremities, with which he was admitted to the neighboring hospital, where he was started on treatment of asthmatic attacks with 30 mg/day of PSL. However, because muscle weakness of his extremities became gradually worse, he was transferred to our hospital. Physical examination on admission revealed an absence of knee and ankle jerk, sensory loss in the bilateral hands, legs and feet and diminished muscle strength of the extremities. Significant laboratory findings included leukocytosis, eosinophilia (4743/mm) and elevated serum IgE concentration (4900 IU/ml). Histologic evidence of vasculitis with an associated infiltration by eosinophils was noted on skin biopsy. These findings led to a diagnosis of Churg-Strauss syndrome. Treatment was started with PSL at 40 mg/day. However, as asthmatic attacks and eosinophilia were refractory to the conventional therapies, concomitant lobenzarit disodium (CCA), 240 mg/day was initiated. On increasing the dosage of CCA to 320 mg/day because of unsatisfactory symptomatic responses elicited at the initial dose level, the patient became free from an asthmatic attack with a return to normal of his eosinophilic count. He was discharged virtually asymptomatic while being placed on a regimen of PSL at 5 mg/day.