Bowel perforations in a patient affected by Churg-Strauss syndrome under high-dose steroid treatment: will alternative drugs reduce risk of surgery?

Rheumatol Int. 2011 Sep;31(9):1239-41. doi: 10.1007/s00296-009-1289-5. Epub 2009 Dec 12.

Abstract

Churg-Strauss syndrome is a relapsing-remitting vasculitis that frequently involves digestive system. Ischemic perforation of the large bowel is relatively rare and potentially life threatening. We report a case treated with high dose of steroids for a relapsing of Churg-Strauss vasculopathy that underwent emergency surgery for multiple large-bowel perforations. Massive use of steroids is common for controlling relapse of this disease, but this increases the risk of intestinal perforation. A prompt switching to alternative drugs when intestinal tract is involved should be considered in order to prevent surgery.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / surgery
  • Acute Disease
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Churg-Strauss Syndrome / diagnosis
  • Churg-Strauss Syndrome / drug therapy*
  • Churg-Strauss Syndrome / surgery
  • Colonic Diseases / chemically induced*
  • Colonic Diseases / prevention & control
  • Glucocorticoids / adverse effects*
  • Glucocorticoids / therapeutic use
  • Humans
  • Ileostomy
  • Intestinal Perforation / chemically induced*
  • Intestinal Perforation / diagnosis
  • Intestinal Perforation / surgery
  • Male
  • Methylprednisolone / adverse effects*
  • Methylprednisolone / therapeutic use
  • Postoperative Complications / drug therapy
  • Respiratory Insufficiency / diagnosis
  • Severity of Illness Index

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids
  • Methylprednisolone