[A case of Churg-Strauss syndrome overlapping with sarcoidosis]

We report a case of a 55-year-old woman with Churg-Strauss syndrome (CSS) overlapping with sarcoidosis. She had suffered from bronchial asthma since she was 42, then was diagnosed with sarcoidosis at the age of 50, with typical bilateral hilar lymphadenopathy and noncaseating granulomas in the specimen from the scalene lymph node biopsy. Five years later she was admitted to our hospital in a state of mild confusion. Since she had mononeuropathy multiplex and positive serum pANCA, in addition to bronchial asthma and marked eosinophilia, she was diagnosed as having CSS too. To the best of our knowledge, no case reports on CSS overlapping with sarcoidosis have yet been published. Although CSS can occur with sarcoidosis merely by chance, both disorders cause systemic granulomatous vasculitis and share several clinical features. Therefore, we speculate that CSS and sarcoidosis share pathogenesis in part and may present a clinical condition in which CSS overlaps with sarcoidosis. The disturbed state of consciousness in this case may be caused by a diffuse cerebral dysfunction from microangiopathy in the brain.