A Case of Churg-Strauss Syndrome Associated with a Leukotriene Receptor Antagonist

Abstract

An icreasing number of reports have indicated that Churg-Strauss syndrome may be associated with leukotriene receptor antagonists. Here in we report Churg-Strauss syndrome in a patient receiving zafirlukast. A forty-nine-year-old man developed palpable purpura on his left flank and extremities. Until then, he had been treated with leukotriene receptor antagonists without systemic steroid for two years. The skin biopsy specimen showed leukocytoclastic vasculitis with fibrinoid degeneration and a cellular infiltrate of lymphocytes and eosinophils in the dermis. Laboratory findings revealed elevation of leucocytes with eosinophilia and a high level of CRP. Based on these findings, he was diagnosed with Churg-Strauss syndrome. Discontinuance of zafirlukast and steroid pulse therapy diminished his eruptions and normalized his laboratory data. The mechanisms of inducing Churg-Strauss syndrome by leukotriene receptor antagonists still remain unclear. However, zafirlukast may have been associated with the onset of Churg-Strauss syndrome in this case.