急激な片側下肢麻ひを伴ったＣｈｕｒｇ‐Ｓｔｒａｕｓｓ症候群の１例

Abstract

Churg-Strauss syndrome is an autoimmune disease characterized by asthma, eosinophilia and systemic necrotizing vasculitis. The authors report the case of a 53-year-old man who developed Churg-Strauss syndrome associated with extremely severe pain and neuralgia of unilateral leg. In the initial four days, he complained of persistent low back pain, and subsequently showed drop foot together with extremely severe pain. MRI examination and diagnostic nerve root block ruled out the involvement of spinal canal disorders including disc herniation. Laboratory and electromyographic examinations revealed hypereosinophilia and low contraction amplitude with normal nerve conduction velocity. Biopsy to skin and muscle tissues, however, failed to detect significant inflammatory reaction around vessels probably due to the relative long-term interval from the onset of the disease. Systemic administration of prednisone for three days dramatically improved the pain. Although the dropped foot still remains, the patient is now receiving physical therapy outside his home. The etiology, diagnostic features, and treatment of Churg-Strauss syndrome have been briefly reviewed, and the pertinent literature discussed.