胃腸および消化器系

抽象的な

Gastrointestinal Manifestations of Churg-Strauss Syndrome

Ellen C. Ebert

Background and Aims: The diagnosis of Churg-Strauss syndrome (CSS), an allergic granulomatosis involving small- and medium-sized vessels, requires the presence of at least four of six criteria including asthma, peripheral eosinophilia, and systemic vasculitis. The gastrointestinal manifestations have never been reviewed.

Methods: The 75 articles in the English literature found by electronic searches from 1960 to 2011 were examined.

Results: Ischemia from vasculitis causes ulcerations, perforation, annular stenosis, and/or intestinal occlusions usually involving the small bowel, presenting as an acute abdomen or intestinal angina. Colonoscopy characteristically shows shallow ulcers with erythematous halos. Endoscopic biopsies usually do not reveal vasculitis as this requires sampling of the submucosa. Intestinal resections reveal eosinophilic infiltrates, vasculitis, fibrinoid necrosis, and/ or granulomas. Unusual complications include acalculous cholecystitis and eosinophilic ascites from involvement of the peritoneum. Most patients respond to corticosteroids although mesenteric ischemia is associated with a poor outcome.

Conclusion: CSS, while rare, has characteristic GI involvement.