摘要
Abstract
Objective To analyze the clinical features, therapy and prognosis of Churg-Strauss syndrome ( CSS) complicated with acute coronary syndrome (ACS). Methods Papers in English published between 1990 and 2010 in Medline database were searched. The reported myocardial infarction or pectoris angina complicating CSS were reviewed and 3 cases in our hospital were analyzed. Results Eleven cases with CSS complicated with ACS were reported, of which 4 patients were male, 7 patients were female. All myocardial infarction or unstable angina pectoris occurred during early active phase of CSS. Acute pressuring chest pain was the most common and indicative feature of ACS, usually with corresponding findings in electrocardiogram and elevated cardiac enzymes. Angiography showed that multiple coronary vasospasm without anatomic stenosis were the main findings (7/10) , aneurysm was rare (1/10). In addition, bronchial asthma (11/11), parasinusitis (7/11) , peripheral neuropathy (5/11), pulmonary infiltration (4/11) and gastrointestinal lesion (3/11) were presented. All cases presented with marked eosinophilia [ ( 1. 2 -29. 6) x 109/L], but negative for anti-neutrophil cytoplasmic antibodies. Acute coronary syndrome might be refractory to vasodila-tor but sensitive to high-dose corticosteroid combined with cyclophosphamide. Conclusion ACS is a rare but life-threatening manifestation of CSS. Coronary spasm with eosinophilia might be the most important cause, which might be unresponsive to vasodilator. Management with high-dose corticosteroid and cyclophosphamide should be recommended, this might improve the prognosis.关键词
Churg-Strauss综合征/急性冠状动脉综合征/冠状动脉痉挛/高嗜酸性粒细胞血症Key words
churg-strauass syndrome/ acute coronary syndrome/ coronary spasm/ hypereosinophilia
Chin J Allergy Clm Immunol, 2011, 5(3):223-227分类
医药卫生
