Churg-Strauss Syndrome After Corticosteroid Withdrawal in Asthma Patients: Report of Two Cases not Related to Ieukotriene Receptor Antagonists

氣喘患者在減用類固醇後出現Churg Strauss syndrome：兩病例報告

楊美貞(Mei-Chen Yang) ； 劉文德(Wen-Te Liu) ； 林鴻銓(Horng-Chyuan Lin) ； 黃崇仁(Chung-Jen Huang) ； 黃秀芬(Shiu-Feng Huang) ； 郭漢彬(Han-Pin Kuo)

《胸腔醫學》 18卷3期 (2003/06) Pp. 251-258

https://doi.org/10.29806/TM.200306.0009

摘要

Leukotriene受體拮抗劑由於其具抗發炎作用而廣泛應用在氣喘控制上，如此可減低類固醇之使用量及其不必要之副作用。近年來學界漸漸注意到某些長期氣喘患者，不論是否有合併Leukotriene受體拮抗劑的使用，在減用類固醇後產生了Churg Strauss Syndrome或其他形式的eosinophilic lung disease。這些病人可能本身即是Churg Strauss Syndrome或其他形式的eosinophilic lung disease，只不過在疾病病程早期只是以氣喘來表現，因而不經意的被類固醇所壓制掉而未被察覺診斷出來。我們在此提出二位長期不穩定氣喘須依賴類固醇的患者，在成功減用類固醇後發現其本身即為Churg Strauss Syndrome病患，而在兩週的低劑量類固醇治療後，其症狀和X光均得到迅速改善。

關鍵字

類固醇依賴性氣喘 ； Leukotriene受體拮抗劑

並列摘要

The standard management of asthma with inhaled corticosteroids and bronchodilators is successful in most patients. Leukotriene receptor antagonists are also universally used for asthma because of their anti-inflammatory potential. In recent years, academic circles have noted that some long-standing asthma patients have developed eosinophilic lung disease after withdrawal of systemic steroids due to the prior administration of inhaled steroids with or without leukotriene receptor antagonists. It was assumed that these patients may have had underlying eosinophilic lung disease with an initial presentation of asthma, which was unwittingly suppressed by previous steroid use.
Herein, we present two cases of allergic-type asthma in which the underlying Churg Strauss syndrome was discovered after systemic steroid withdrawal. The symptoms and radiographic abnormalities of Churg Strauss syndrome were improved after two weeks of resumed steroid treatment.

並列關鍵字

steroid-dependent asthma ； Churg Strauss syndrome ； leukotriene receptor antagonist ； eosinophilic lung disease