- 期刊
Development of Churg Strauss Syndrome in an Asthma Patient Taking Montelukast
使用Montelukast的氣喘病人發生的Churg-Strauss症候群
摘要
目前為止，只有極少數的病例報告提到白三烯受體拮抗劑（leukotriene receptor antagonist）與Churg-Strauss症候群的關係，因此兩者之間的確切關聯性尚未被清楚的建立。這位69歲的氣喘病患在使用montelukast兩週後，發生雙下肢麻及無力的情形。神經傳導速度檢查顯示軸突退化性多神經病變。血液檢驗報告發現嗜伊紅血球增多（21.53 × 10^3/uL）及高濃度的免疫球蛋白IgE（2,768 IU/mL）。非固定性（non-fixed）的雙側肺炎在停用montelukast及使用類固醇後，得到顯著的改善。此外，Water's view顯示雙側上頜竇炎。綜合以上的發現：氣喘、嗜伊紅血球增多、多神經病變、鼻竇炎、非固定性肺浸潤，此病患診斷為Churg-Strauss症候群。就我們所知，Montelukast在用於治療氣喘上，是安全且有效的藥物，但它與Churg-Strauss症候群之間的關連性，仍需小心注意。
並列摘要
A very limited number of reports have documented the association between leukotriene receptor antagonist (LTRA) and Churg-Strauss syndrome (CSS), but to date, a clear relationship has not been established because of its rarity.We report a 69-year-old asthma patient who suffered from progressive bilateral lower legs numbness and weakness about 2 weeks after taking montelukast. Nerve conduction velocity (NCV) showed axonal degenerative polyneuropathy. Because of shortness of breath, she was admitted soon after these symptoms were noted. The initial laboratory analyses showed eosinophilia (74% of white cell count) with a high total IgE level (2,768 IU/mL). Chest radiograph revealed non-fixed bilateral pneumonia. Dramatic resolution of the pneumonia with steroid treatment was achieved and montelukast treatment was stopped. In addition, Waters' view showed bilateral maxillary sinusitis. With the above findings, including asthma, marked eosinophilia, polyneuropathy, sinusitis, and non-fixed radiographic pulmonary infiltrates, CSS was diagnosed. We believe that montelukast is a useful and relatively safe drug for treating asthma, but care should be taken regarding its linkage with CSS.
延伸閱讀
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- 沈振榮、林自強、張兩溉（2000）。類固醇不反應性氣喘病人之methortrexate治療。當代醫學，(316)，155-160。https://doi.org/10.29941/MT.200002.0020
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