Medscape is available in 5 Language Editions – Choose your Edition here.


Churg-Strauss Disease Medication

  • Author: Robert Stanley Rust, Jr, MD, MA; Chief Editor: Amy Kao, MD  more...
Updated: Oct 13, 2014

Medication Summary

For most patients, Churg-Strauss disease (CSD) is a readily treatable illness, and reports over the past few decades have shown better outcomes than were demonstrated in earlier case series. In part, this may be due to the inclusion of milder cases due to improved recognition. In particular, diagnostic sensitivity has been greatest for individuals whose initial presentation is with asthma (90% of cases in some case series). However, a major factor has been the availability of corticosteroids. Milder CSD may respond well to orally administered corticosteroids.

The recommended initial medications for treatment of severe manifestations of CSD, including patients with CSD–related peripheral neuritis, are corticosteroids, which are administered at high doses. Intravenous administration of methylprednisolone at doses of 15 mg/kg on 1-3 successive mornings is one of the most common initial approaches to severe cases. Rapid correction of eosinophilia, leukocytosis, and elevations of sedimentation rate and LDH are characteristic of CSD. Failure to provoke such corrections early in the course of therapy is associated with elevated risk for poor long-term outcome.

Intravenous treatment is followed by oral prednisone at a dose of approximately 1 mg/kg/d (usual, but absolute maximal daily dose should not exceed 80 mg/d), with ensuing taper once clinical improvement is noted.

Many patients with CSD manifest a favorable response to this monotherapeutic approach within a few days; however, in many cases, persistence of asthma prevents oral prednisone from being tapered to doses lower than 10-15 mg/d. In milder cases, initial treatment can be undertaken with the administration of oral corticosteroids at doses of 1 mg/kg/d (60 mg/d is the usual but not absolute maximal dose).

Corticosteroid treatment, whether oral or intravenous, has been combined with plasma exchange or plasmapheresis for cases that were difficult to treat. This combination appears to have conferred benefit in some patients. Some patients have demonstrated marked clinical improvement, accompanied by declining circulating pANCA titers, after treatment with intravenous immunoglobulin (IVIg). Some patients have been treated, either initially or during a subsequent phase of therapy, with the combination of daily oral prednisone and cyclophosphamide. This approach may enhance disease control and may have a sparing effect upon steroid dosage, thus diminishing steroid-related adverse effects. Prednisone taper in patients responding to the combined therapy can be undertaken after approximately 2 weeks.

The combination of high-dose corticosteroids and dapsone has been used in patients with severe Churg-Strauss disease and has proven effective in instances of Churg-Strauss myocarditis.[28] Corticosteroid doses may be reduced after improvement in myocarditis is achieved.

Cyclophosphamide treatment (titrated to the neutrophil count) generally is continued for 6-12 months after remission is established. Pulse intravenous cyclophosphamide therapy in combination with corticosteroids appears to diminish the risk for various adverse effects seen in patients receiving oral cyclophosphamide daily. This form of therapy is also considered in patients whose disease responds poorly to corticosteroids. Dose, frequency, and total number of cyclophosphamide pulses are adjusted to disease response, blood counts, and renal function. Efficacy of this form of therapy is not, as yet, fully established.

Usually, collaborating with physicians specializing in renal medicine is the best way to undertake this form of therapy. Protocols must be utilized to ensure that renal function is preserved with regard to additionally administered medications and hydration. These protocols entail intense hydration and coadministration of 2-mercaptoethanesulfonate (mesna). Some studies have used initial pulse intravenous cyclophosphamide at doses as high as 0.6 g/m2 of body surface, but this dose must be reduced in accordance with the degree of impairment of renal function exhibited by the patient.

Azathioprine, methotrexate, or ribavirin have possible roles in the treatment of CSD, but these drugs require additional study and should not be used without the participation of a subspecialist who can provide recommendations concerning dosage, anticipated benefits, and adverse effects.

The suggestion has been made that males with CSD might attain some benefit from treatment with thalidomide. This approach requires considerable additional study and the participation of an expert who can provide information concerning appropriate dosage, anticipated benefits, and adverse effects. The use of thalidomide is contraindicated in women of childbearing age. None of the drugs noted in this paragraph should be used without the collaboration of subspecialists skilled in their use and familiar with the relative indications, dosage adjustments, potential benefits, and adverse effects. Therefore, none of these agents are reviewed in the following Medication section because the complex issues entailed with their use fall beyond the scope of this article.



Class Summary

These medications decrease the activity of the immune system in inflammatory reactions. The immune system is of critical importance in the pathophysiology of this disease.

Methylprednisolone (Medrol, Solu-Medrol, Depo-Medrol)


Moderate or severe cases often treated for 1-3 d with IV methylprednisolone (or equivalent dose of some other anti-inflammatory corticosteroid). Administer initial dose under close supervision, since rare instances of anaphylaxis after initial dose have been reported.

Prednisone (Sterapred)


Useful in initial management of mild cases (especially for asthma) and in taper and maintenance phases of therapy for Churg-Strauss disease.


Cytotoxic agents

Class Summary

These agents inhibit cell growth and proliferation, reducing the activity of the immune system.

Cyclophosphamide (Cytoxan)


Synthetic drug, chemically related to nitrogen mustards, developed as antineoplastic agent. Biotransformed in liver, where constituent alkylating metabolites activated. These activated compounds interfere with growth of susceptible rapidly proliferating cells. Mechanism of action with regard to tumor cells may involve cross-linking of tumor cell DNA.

Contributor Information and Disclosures

Robert Stanley Rust, Jr, MD, MA Thomas E Worrell Jr Professor of Epileptology and Neurology, Co-Director of FE Dreifuss Child Neurology and Epilepsy Clinics, Director, Child Neurology, University of Virginia School of Medicine; Chair-Elect, Child Neurology Section, American Academy of Neurology

Robert Stanley Rust, Jr, MD, MA is a member of the following medical societies: Child Neurology Society, Society for Pediatric Research, American Headache Society, International Child Neurology Association, American Academy of Neurology, American Epilepsy Society, American Neurological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Kenneth J Mack, MD, PhD Senior Associate Consultant, Department of Child and Adolescent Neurology, Mayo Clinic

Kenneth J Mack, MD, PhD is a member of the following medical societies: American Academy of Neurology, Child Neurology Society, Phi Beta Kappa, Society for Neuroscience

Disclosure: Nothing to disclose.

Chief Editor

Amy Kao, MD Attending Neurologist, Children's National Medical Center

Amy Kao, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, Child Neurology Society

Disclosure: Have stock from Cellectar Biosciences; have stock from Varian medical systems; have stock from Express Scripts.

Additional Contributors

Robert J Baumann, MD Professor of Neurology and Pediatrics, Department of Neurology, University of Kentucky College of Medicine

Robert J Baumann, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pediatrics, Child Neurology Society

Disclosure: Nothing to disclose.

  1. Davies DJ, Moran JE. Segmental necrotizing glomerulonephritis with antineutrophil antibody: possible arbovirus aetiology?. BMJ. 1982. 285:606.

  2. Churg J, Strauss L. Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am J Pathol. 1951 Mar-Apr. 27(2):277-301. [Medline].

  3. Chumbley LC, Harrison EG Jr, DeRemee RA. Allergic granulomatosis and angiitis (Churg-Strauss syndrome). Report and analysis of 30 cases. Mayo Clin Proc. 1977 Aug. 52(8):477-84. [Medline].

  4. Lanham JG. Churg-Strauss syndrome. Br J Hosp Med. 1992 May 6-19. 47(9):667-73. [Medline].

  5. Masi AT, Hunder GG, Lie JT, et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum. 1990 Aug. 33(8):1094-100. [Medline].

  6. Jennette JC, Falk RJ, Andrassy K, et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum. 1994 Feb. 37(2):187-92. [Medline].

  7. Lie JT. Nomenclature and classification of vasculitis: plus ça change, plus c'est la même chose. Arthritis Rheum. 1994 Feb. 37(2):181-6. [Medline].

  8. Kallenberg CG, Brouwer E, Weening JJ, Tervaert JW. Anti-neutrophil cytoplasmic antibodies: current diagnostic and pathophysiological potential. Kidney Int. 1994 Jul. 46(1):1-15. [Medline].

  9. Cohen P, Guillevin L, Baril L, Lhote F, Noel LH, Lesavre P. Persistence of antineutrophil cytoplasmic antibodies (ANCA) in asymptomatic patients with systemic polyarteritis nodosa or Churg-Strauss syndrome: follow-up of 53 patients. Clin Exp Rheumatol. 1995 Mar-Apr. 13(2):193-8. [Medline].

  10. Tervaert JW, Goldschmeding R, Elema JD, von dem Borne AE, Kallenberg CG. Antimyeloperoxidase antibodies in the Churg-Strauss syndrome. Thorax. 1991 Jan. 46(1):70-1. [Medline].

  11. Tervaert JW, Goldschmeding R, Elema JD, et al. Association of autoantibodies to myeloperoxidase with different forms of vasculitis. Arthritis Rheum. 1990 Aug. 33(8):1264-72. [Medline].

  12. Watts RA, Scott DG. Classification and epidemiology of the vasculitides. Baillieres Clin Rheumatol. 1997 May. 11(2):191-217. [Medline].

  13. Capizzi SA, Specks U. Does infection play a role in the pathogenesis of pulmonary vasculitis?. Semin Respir Infect. 2003 Mar. 18(1):17-22. [Medline].

  14. Ramentol-Sintas M, Martínez-Valle F, Solans-Laqué R. Churg-Strauss Syndrome: An evolving paradigm. Autoimmun Rev. 2012 Dec. 12(2):235-40. [Medline].

  15. Wiik A. Autoantibodies in vasculitis. Arthritis Res Ther. 2003. 5(3):147-52. [Medline].

  16. Arm JP, Lee TH. Sulphidopeptide leukotrienes in asthma. Clin Sci (Lond). 1993 May. 84(5):501-10. [Medline].

  17. Drazen JM, Israel E. Should antileukotriene therapies be used instead of inhaled corticosteroids in asthma? Yes. Am J Respir Crit Care Med. 1998 Dec. 158(6):1697-8. [Medline].

  18. Drazen JM, Israel E, O'Byrne PM. Treatment of asthma with drugs modifying the leukotriene pathway. N Engl J Med. 1999 Jan 21. 340(3):197-206. [Medline].

  19. Wechsler ME, Garpestad E, Flier SR, et al. Pulmonary infiltrates, eosinophilia, and cardiomyopathy following corticosteroid withdrawal in patients with asthma receiving zafirlukast. JAMA. 1998 Feb 11. 279(6):455-7. [Medline].

  20. Churg A, Brallas M, Cronin SR, Churg J. Formes frustes of Churg-Strauss syndrome. Chest. 1995 Aug. 108(2):320-3. [Medline].

  21. D'Cruz DP, Barnes NC, Lockwood CM. Difficult asthma or Churg-Strauss syndrome?. BMJ. 1999 Feb 20. 318(7182):475-6. [Medline].

  22. Garcia-Marcos L, Schuster A, Perez-Yarza EG. Benefit-risk assessment of antileukotrienes in the management of asthma. Drug Saf. 2003. 26(7):483-518. [Medline].

  23. Kemp JP. Recent advances in the management of asthma using leukotriene modifiers. Am J Respir Med. 2003. 2(2):139-56. [Medline].

  24. Finkel TH, Hunter DJ, Paisley JE, Finkel RS, Larsen GL. Drug-induced lupus in a child after treatment with zafirlukast (Accolate). J Allergy Clin Immunol. 1999 Mar. 103(3 Pt 1):533-4. [Medline].

  25. Haim DY, Lippmann ML, Goldberg SK, Walkenstein MD. The pulmonary complications of crack cocaine. A comprehensive review. Chest. 1995 Jan. 107(1):233-40. [Medline].

  26. Orriols R, Munoz X, Ferrer J, Huget P, Morell F. Cocaine-induced Churg-Strauss vasculitis. Eur Respir J. 1996 Jan. 9(1):175-7. [Medline].

  27. Guillevin L, Cohen P, Gayraud M, Lhote F, Jarrousse B, Casassus P. Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients. Medicine (Baltimore). 1999 Jan. 78(1):26-37. [Medline].

  28. Shanks M, Ignaszewski AP, Chan SY, Allard MF. Churg-Strauss syndrome with myocarditis manifesting as acute myocardial infarction with cardiogenic shock: case report and review of the literature. Can J Cardiol. 2003 Sep. 19(10):1184-8. [Medline].

  29. Lin YC, Oliveira GH, Villa-Forte A. Churg-Strauss syndrome and persistent heart failure: active disease or damage?. J Clin Rheumatol. 2013 Oct. 19(7):390-2; discussion 419. [Medline].

  30. Tatsukawa H, Nagano S, Umeno Y, Oribe M. Churg-strauss syndrome with cholecystitis and renal involvement. Intern Med. 2003 Sep. 42(9):893-6. [Medline].

  31. Lane SE, Watts R, Scott DG. Epidemiology of systemic vasculitis. Curr Rheumatol Rep. 2005 Aug. 7(4):270-5. [Medline].

  32. Booth AD, Almond MK, Burns A, et al. Outcome of ANCA-associated renal vasculitis: a 5-year retrospective study. Am J Kidney Dis. 2003 Apr. 41(4):776-84. [Medline].

  33. Kawakami T, Soma Y, Kawasaki K, Kawase A, Mizoguchi M. Initial cutaneous manifestations consistent with mononeuropathy multiplex in Churg-Strauss syndrome. Arch Dermatol. 2005 Jul. 141(7):873-8. [Medline].

  34. Eyler AE, Ahmad FA, Jahangir E. Magnetic resonance imaging of the cardiac manifestations of Churg-Strauss. JRSM Open. 2014 Apr. 5(4):2054270414525370. [Medline]. [Full Text].

  35. Abril A, Calamia KT, Cohen MD. The Churg Strauss syndrome (allergic granulomatous angiitis): review and update. Semin Arthritis Rheum. 2003 Oct. 33(2):106-14. [Medline].

  36. Azzopardi C, Montefort S, Mallia C. Cardiac involvement and left ventricular failure in a patient with the Churg-Strauss syndrome. Adv Exp Med Biol. 1999. 455:547-9. [Medline].

  37. Barry C, Davis S, Garrard P, Ferguson IT. Churg-Strauss disease: deterioration in a twin pregnancy. Successful outcome following treatment with corticosteroids and cyclophosphamide. Br J Obstet Gynaecol. 1997 Jun. 104(6):746-7. [Medline].

  38. Berger JR, Wei T, Wilson D. Idiopathic granulomatous angiitis of the CNS manifesting as diffuse white matter disease. Neurology. 1998 Dec. 51(6):1774-5. [Medline].

  39. Bili A, Condemi JJ, Bottone SM, Ryan CK. Seven cases of complete and incomplete forms of Churg-Strauss syndrome not related to leukotriene receptor antagonists. J Allergy Clin Immunol. 1999 Nov. 104(5):1060-5. [Medline].

  40. Boggi U, Mosca M, Giulianotti PC, Naccarato AG, Bombardieri S, Mosca F. Surviving catastrophic gastrointestinal involvement due to Churg-Strauss syndrome: report of a case. Hepatogastroenterology. 1997 Jul-Aug. 44(16):1169-71. [Medline].

  41. Brooklyn TN, Prouse P, Portmann B, Ramage JK. Churg-Strauss syndrome and granulomatous cholangiopathy. Eur J Gastroenterol Hepatol. 2000 Jul. 12(7):809-11. [Medline].

  42. Bruce IN, Bell AL. A comparison of two nomenclature systems for primary systemic vasculitis. Br J Rheumatol. 1997 Apr. 36(4):453-8. [Medline].

  43. Burke AP, Sobin LH, Virmani R. Localized vasculitis of the gastrointestinal tract. Am J Surg Pathol. 1995 Mar. 19(3):338-49. [Medline].

  44. Caballero J, Zayas R, Arana R, Cano L, Berruezo A, Pinero C. [Churg-Strauss syndrome with pericardial and myocardial involvement]. Rev Esp Cardiol. 1999 Sep. 52(9):745-7. [Medline].

  45. Chen KR, Su WP, Pittelkow MR, Leiferman KM. Eosinophilic vasculitis syndrome: recurrent cutaneous eosinophilic necrotizing vasculitis. Semin Dermatol. 1995 Jun. 14(2):106-10. [Medline].

  46. Cho KH, Kim YG, Yang SG, Lee DY, Chung JH. Inflammatory nodules of the lower legs: a clinical and histological analysis of 134 cases in Korea. J Dermatol. 1997 Aug. 24(8):522-9. [Medline].

  47. Davis MD, Daoud MS, McEvoy MT, Su WP. Cutaneous manifestations of Churg-Strauss syndrome: a clinicopathologic correlation. J Am Acad Dermatol. 1997 Aug. 37(2 Pt 1):199-203. [Medline].

  48. Dietz A, Hubner C, Andrassy K. [Macrolide antibiotic-induced vasculitis (Churg-Strauss syndrome)]. Laryngorhinootologie. 1998 Feb. 77(2):111-4. [Medline].

  49. Dillon MJ. Childhood vasculitis. Lupus. 1998. 7(4):259-65. [Medline].

  50. Dinç A, Soy M, Pay S, Simsek I, Erdem H, Sobaci G. A case of Churg-Strauss syndrome presenting with cortical blindness. Clin Rheumatol. 2000. 19(4):318-20. [Medline].

  51. Eustace JA, Nadasdy T, Choi M. Disease of the month. The Churg Strauss Syndrome. J Am Soc Nephrol. 1999 Sep. 10(9):2048-55. [Medline].

  52. Falk RJ, Nachman PH, Hogan SL, Jennette JC. ANCA glomerulonephritis and vasculitis: a Chapel Hill perspective. Semin Nephrol. 2000 May. 20(3):233-43. [Medline].

  53. Ferro JM. Vasculitis of the central nervous system. J Neurol. 1998 Dec. 245(12):766-76. [Medline].

  54. Gross WL, Csernok E. Immunodiagnostic and pathophysiologic aspects of antineutrophil cytoplasmic antibodies in vasculitis. Curr Opin Rheumatol. 1995 Jan. 7(1):11-9. [Medline].

  55. Guillevin L, Fain O, Lhote F, et al. Lack of superiority of steroids plus plasma exchange to steroids alone in the treatment of polyarteritis nodosa and Churg-Strauss syndrome. A prospective, randomized trial in 78 patients. Arthritis Rheum. 1992 Feb. 35(2):208-15. [Medline].

  56. Hagen EC, Andrassy K, Csernok E, et al. Development and standardization of solid phase assays for the detection of anti-neutrophil cytoplasmic antibodies (ANCA). A report on the second phase of an international cooperative study on the standardization of ANCA assays. J Immunol Methods. 1996 Sep 13. 196(1):1-15. [Medline].

  57. Hauschild S, Csernok E, Schmitt WH, Gross WL. Antineutrophil cytoplasmic antibodies in systemic polyarteritis nodosa with and without hepatitis B virus infection and Churg-Strauss syndrome--62 patients. J Rheumatol. 1994 Jun. 21(6):1173-4. [Medline].

  58. Hellemans S, Dens J, Knockaert D. Coronary involvement in the Churg-Strauss syndrome. Heart. 1997 Jun. 77(6):576-8. [Medline]. [Full Text].

  59. Hellmich B, Csernok E, Gross WL. Proinflammatory cytokines and autoimmunity in Churg-Strauss syndrome. Ann N Y Acad Sci. 2005 Jun. 1051:121-31. [Medline].

  60. Hellmich B, Ehlers S, Csernok E, Gross WL. Update on the pathogenesis of Churg-Strauss syndrome. Clin Exp Rheumatol. 2003 Nov-Dec. 21(6 Suppl 32):S69-77. [Medline].

  61. Hellmich B, Gross WL. Recent progress in the pharmacotherapy of Churg-Strauss syndrome. Expert Opin Pharmacother. 2004 Jan. 5(1):25-35. [Medline].

  62. Hoffman PM, Godfrey T, Stawell RJ. A case of Churg-Strauss syndrome with visual loss following central retinal artery occlusion. Lupus. 2005. 14(2):174-5. [Medline].

  63. Jennette JC, Wilkman AS, Falk RJ. Anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis and vasculitis. Am J Pathol. 1989 Nov. 135(5):921-30. [Medline].

  64. Kim Y, Lee KS, Choi DC, Primack SL, Im JG. The spectrum of eosinophilic lung disease: radiologic findings. J Comput Assist Tomogr. 1997 Nov-Dec. 21(6):920-30. [Medline].

  65. Klemmer PJ, Chalermskulrat W, Reif MS, Hogan SL, Henke DC, Falk RJ. Plasmapheresis therapy for diffuse alveolar hemorrhage in patients with small-vessel vasculitis. Am J Kidney Dis. 2003 Dec. 42(6):1149-53. [Medline].

  66. Lamprecht P. Off balance: T-cells in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides. Clin Exp Immunol. 2005 Aug. 141(2):201-10. [Medline].

  67. Lamprecht P. TNF-alpha inhibitors in systemic vasculitides and connective tissue diseases. Autoimmun Rev. 2005 Jan. 4(1):28-34. [Medline].

  68. Langford CA, Sneller MC. New developments in the treatment of Wegener's granulomatosis, polyarteritis nodosa, microscopic polyangiitis, and Churg-Strauss syndrome. Curr Opin Rheumatol. 1997 Jan. 9(1):26-30. [Medline].

  69. Lhote F, Cohen P, Genereau T, Gayraud M, Guillevin L. Microscopic polyangiitis: clinical aspects and treatment. Ann Med Interne (Paris). 1996. 147(3):165-77. [Medline].

  70. Lie JT. Histopathologic specificity of systemic vasculitis. Rheum Dis Clin North Am. 1995 Nov. 21(4):883-909. [Medline].

  71. Marmursztejn J, Guillevin L, Trebossen R, Cohen P, Guilpain P, Pagnoux C, et al. Churg-Strauss syndrome cardiac involvement evaluated by cardiac magnetic resonance imaging and positron-emission tomography: a prospective study on 20 patients. Rheumatology (Oxford). 2012 Aug 29. [Medline].

  72. Martin-Suarez I, D'Cruz D, Mansoor M, Fernandes AP, Khamashta MA, Hughes GR. Immunosuppressive treatment in severe connective tissue diseases: effects of low dose intravenous cyclophosphamide. Ann Rheum Dis. 1997 Aug. 56(8):481-7. [Medline].

  73. Matsuo K, Tomioka T, Tajima Y, et al. Allergic granulomatous angitis (Churg-Strauss syndrome) with multiple intestinal fistulas. Am J Gastroenterol. 1997 Oct. 92(10):1937-8. [Medline].

  74. Metzler C, Lamprecht P, Hellmich B, Reuter M, Arlt AC, Gross WL. Leucoencephalopathy after treatment of Churg-Strauss syndrome with interferon {alpha}. Ann Rheum Dis. 2005 Aug. 64(8):1242-3. [Medline].

  75. Moosig F, Bremer JP, Hellmich B, Holle JU, Holl-Ulrich K, Laudien M, et al. A vasculitis centre based management strategy leads to improved outcome in eosinophilic granulomatosis and polyangiitis (Churg-Strauss, EGPA): monocentric experiences in 150 patients. Ann Rheum Dis. 2012 Aug 11. [Medline].

  76. Muschen M, Warskulat U, Perniok A, et al. Involvement of soluble CD95 in Churg-Strauss syndrome. Am J Pathol. 1999 Sep. 155(3):915-25. [Medline].

  77. Niles JL. Antineutrophil cytoplasmic antibodies in the classification of vasculitis. Annu Rev Med. 1996. 47:303-13. [Medline].

  78. Pellissier JF, Figarella-Branger D, Serratrice G. [Neuromuscular diseases with eosinophilia]. Med Trop (Mars). 1998. 58(4 Suppl):471-6. [Medline].

  79. Primack SL, Müller NL. Radiologic manifestations of the systemic autoimmune diseases. Clin Chest Med. 1998 Dec. 19(4):573-86, vii. [Medline].

  80. Reid AJC, Harrison RA, Watkin SW, McCann BG, and Scott DGI. Churg-Strauss syndrome in a district hospital. Q J Med. 1998. 91:219-229.

  81. Rutgers A, Heeringa P, Tervaert JW. The role of myeloperoxidase in the pathogenesis of systemic vasculitis. Clin Exp Rheumatol. 2003 Nov-Dec. 21(6 Suppl 32):S55-63.

  82. Sable-Fourtassou R, Cohen P, Mahr A, et al. Antineutrophil cytoplasmic antibodies and the Churg-Strauss syndrome. Ann Intern Med. 2005 Nov 1. 143(9):632-8. [Medline].

  83. Sakamoto S, Ohba S, Eguchi K, et al. Churg-Strauss syndrome presenting with subarachnoid hemorrhage from ruptured dissecting aneurysm of the intracranial vertebral artery. Clin Neurol Neurosurg. 2005 Aug. 107(5):428-31. [Medline].

  84. Sanders JS, Stegeman CA, Kallenberg CG. The Th1 and Th2 paradigm in ANCA-associated vasculitis. Kidney Blood Press Res. 2003. 26(4):215-20. [Medline].

  85. Sharma BK, Daga MK, Sharma M. A limited form of Churg-Strauss syndrome presenting without asthma and eosinophilia. Med J Aust. 2004 Nov 1. 181(9):498-9. [Medline].

  86. Somogyi A, Muzes G, Molnar J, Tulassay Z. Drug-related Churg-Strauss syndrome?. Adverse Drug React Toxicol Rev. 1998 Jun-Sep. 17(2-3):63-74. [Medline].

  87. Sonneville R, Lagrange M, Guidoux C, et al. [The association of cardiac involvement and ischemic stroke in Churg Strauss syndrome]. Rev Neurol (Paris). 2006 Feb. 162(2):229-32. [Medline].

  88. Steinfeld S, Golstein M, De Vuyst P. Chronic eosinophilic pneumonia (CEP) as a presenting feature of Churg-Strauss syndrome (CSS). Eur Respir J. 1994 Nov. 7(11):2098. [Medline].

  89. Sudo K, Tashiro K. Idiopathic granulomatous angiitis of the CNS manifesting as diffuse white matter disease. Neurology. 1998 Dec. 51(6):1774; author reply 1775. [Medline].

  90. Sullivan EJ, Hoffman GS. Pulmonary vasculitis. Clin Chest Med. 1998 Dec. 19(4):759-76, ix. [Medline].

  91. Tatsis E, Schnabel A, Gross WL. Interferon-alpha treatment of four patients with the Churg-Strauss syndrome. Ann Intern Med. 1998 Sep 1. 129(5):370-4. [Medline].

  92. Terasaki F, Hayashi T, Hirota Y, et al. Evolution to dilated cardiomyopathy from acute eosinophilic pancarditis in Churg-Strauss syndrome. Heart Vessels. 1997. 12(1):43-8. [Medline].

  93. Thuy GN, Cuguilliere A, Arteaga C, Miltgen J, Bonnet D. [Idiopathic chronic eosinophilic pneumonia]. Med Trop (Mars). 1998. 58(4 Suppl):455-8. [Medline].

  94. Vital C, Vital A, Canron MH, et al. Combined nerve and muscle biopsy in the diagnosis of vasculitic neuropathy. A 16-year retrospective study of 202 cases. J Peripher Nerv Syst. 2006 Mar. 11(1):20-9. [Medline].

  95. Watts RA, Lane SE, Bentham G, Scott DG. Epidemiology of systemic vasculitis: a ten-year study in the United Kingdom. Arthritis Rheum. 2000 Feb. 43(2):414-9. [Medline].

  96. Weissler JC. Syndromes of severe asthma. Am J Med Sci. 2000 Mar. 319(3):166-76. [Medline].

  97. Wolf M, Rose H, Smith RN. Case records of the Massachusetts General Hospital. Case 28-2005. A 42-year-old man with weight loss, weakness, and a rash. N Engl J Med. 2005 Sep 15. 353(11):1148-57. [Medline].

  98. Yoshihara K, Arimura Y, Kobayashi O, et al. [Clinical study on five myeloperoxidase specific anti-neutrophil cytoplasmic antibody (MPO-ANCA) positive Churg-Strauss syndrome cases]. Ryumachi. 1998 Oct. 38(5):696-704. [Medline].

  99. Zhao MH, Short AK, Lockwood CM. Antineutrophil cytoplasm autoantibodies and vasculitis. Curr Opin Hematol. 1995 Jan. 2(1):96-102. [Medline].

All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.