A case of Churg-Strauss syndrome whose diagnosis was given without the findings of systemic vasculitis and granulomatous angiitis.

We reported here a case of Churg-Strauss syndrome whose diagnosis was given without the findings of systemic vasculitis and granulomatous angiitis. The patient was a 58 year-old female who has been followed at outpatient clinic in our hospital with the diagnosis of bronchial asthma. She admitted our hospital on May 27, 1999 with migrating polymyalgia, polyarthralgia and granulomatous skin lesions on her left forearm. In laboratory data, we found a significant eosinophilia in the peripheral blood, accelerated erythrocyte sedimentation rate, elevation of CRP, and so on. Pulmonary infiltrates were also found on the chest X-ray examination. However, any findings which suggested the presence of systemic vasculitis such as high fever were not found.From her clinical course and laboratory findings, we gave her the diagnosis of Churg-Strauss syndrome based on the criteria for Churg-Strauss syndrome and the classification tree proposed by the American College of Rheumatology. Biopsy specimen from the skin lesion showed diffuse extravascular infiltration of eosinophils and neutrophils into dermis without the findings of granulomatous angiitis. She was successfully treated by corticosteroid, and discharged on August 20, 1999.