Effective intravenous immunoglobulin therapy for Churg-Strauss syndrome allergic granulomatous angiitis complicated by neuropathy of the eighth cranial nerve: a case reportReportar como inadecuado




Effective intravenous immunoglobulin therapy for Churg-Strauss syndrome allergic granulomatous angiitis complicated by neuropathy of the eighth cranial nerve: a case report - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal of Medical Case Reports

, 6:310

First Online: 18 September 2012Received: 09 March 2012Accepted: 31 July 2012DOI: 10.1186-1752-1947-6-310

Cite this article as: Ozaki, Y., Tanaka, A., Shimamoto, K. et al. J Med Case Reports 2012 6: 310. doi:10.1186-1752-1947-6-310

Abstract

IntroductionWe report the case of a patient with Churg-Strauss syndrome with eighth cranial nerve palsy. Vestibulocochlear nerve palsy is extremely rare in Churg-Strauss syndrome. To the best of our knowledge, only one case of complicated neuropathy of the eighth cranial nerve has been described in a previous report presenting an aggregate calculation, but no differentiation between polyarteritis nodosa and Churg-Strauss syndrome was made. High-dose immunoglobulin was administered to our patient, and her neuropathy of the eighth cranial nerve showed improvement.

Case presentationAt the age of 46, a Japanese woman developed Churg-Strauss syndrome that later became stable with low-dose prednisolone treatment. At the age of 52, she developed sudden difficulty of hearing in her left ear, persistent severe rotary vertigo, and mononeuritis multiplex. At admission, bilateral perceptive deafness of about 80dB and eosinophilia of 4123-μL in peripheral blood were found. A diagnosis of cranial neuropathy of the eighth cranial nerve associated with exacerbated Churg-Strauss syndrome was made. Although high doses of steroid therapy alleviated the inflammatory symptoms and markers, the vertigo and bilateral hearing loss remained. Addition of a high-dose immunoglobulin finally resulted in marked alleviation of the symptoms associated with neuropathy of the eighth cranial nerve.

ConclusionsA high dose of immunoglobulin therapy shows favorable effects in neuropathy of the eighth cranial nerve, but no reports regarding its efficacy in cranial neuropathy have been published.

KeywordsChurg-Strauss syndrome Cranial neuropathy Intravenous immunoglobulin AbbreviationsCRPC-reactive protein

CSSChurg-Strauss syndrome

IFNγinterferon-gamma

ILinterleukin

IVCYintravenous cyclophosphamide

IVIgintravenous immunoglobulin

MPO-ANCAmyeloperoxidase anti-neutrophil cytoplasmic antibody

mPSLmethyl-prednisolone pulse therapy

PSLprednisolone.

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Autor: Yoshio Ozaki - Akihiro Tanaka - Keiko Shimamoto - Hideki Amuro - Yonsu Son - Tomoki Ito - Shosaku Nomura

Fuente: https://link.springer.com/







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