Cardiogenic Shock: An Unusual Initial Presentation of Churg-Strauss Syndrome.
M ApiramiJ A PratheepanThirunavukarasu KumananM GuruparanG SelvaratnamPublished in: Case reports in rheumatology (2018)
Churg-Strauss syndrome (CSS) is a rare autoimmune condition, characterized by necrotizing extravascular eosinophil rich granulomatous inflammation of the tissues and disseminated small-medium sized vessel vasculitis in a patient with bronchial asthma and tissue eosinophilia. Though pulmonary involvement is the predominant feature of CSS, extra pulmonary involvement, in particular, cardiac involvement, denotes an adverse outcome. Here we report a 50-year-old female who presented with cardiogenic shock due to an acute coronary event as the initial manifestation of CSS. A subsequent coronary angiogram revealed normal epicardial coronaries. She was a patient with bronchial asthma and developed vasculitic rash, bilateral sensory motor polyneuropathy, and migratory peripheral lung field shadows in the background of peripheral eosinophilia during the course of the illness. She was diagnosed as having CSS based on ACR criteria and aggressively treated with immunosuppressants according to her Five-Factor Score and has shown prompt response to therapy. This case report adds to the literature another rare initial presentation of CSS to the existing array of its clinical manifestations.
Keyphrases
- case report
- coronary artery disease
- pulmonary hypertension
- chronic obstructive pulmonary disease
- coronary artery
- lung function
- oxidative stress
- liver failure
- multiple sclerosis
- allergic rhinitis
- systematic review
- machine learning
- drug induced
- left ventricular
- gene expression
- high throughput
- emergency department
- rheumatoid arthritis
- high resolution
- single cell
- interstitial lung disease
- deep learning
- systemic sclerosis
- intensive care unit
- mesenchymal stem cells
- aortic stenosis
- acute respiratory distress syndrome
- transcatheter aortic valve replacement
- atrial fibrillation
- high density
- newly diagnosed
- extracorporeal membrane oxygenation
- idiopathic pulmonary fibrosis
- aortic dissection