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Yeungnam Univ J Med > Volume 32(2); 2015 > Article
Yeungnam University Journal of Medicine 2015;32(2):127-131.
DOI: https://doi.org/10.12701/yujm.2015.32.2.127    Published online December 31, 2015.
An overlap syndrome of Churg-Strauss syndrome and rheumatoid arthritis.
Seung Il Bae, Jong Geol Jang, Hun Tae Kim, Hee Yun Ahn, Min Jung Kim, Hyun Je Kim, Choong Ki Lee, Young Hoon Hong
Division of Rheumatology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea. yhhongdr@yahoo.co.kr
Abstract
Churg-Strauss syndrome (CSS) is a necrotizing vasculitis with extra-, peri-vascular eosinophilic infiltration. Chronic symmetric polyarthritis with the presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody are the mainstay of rheumatoid arthritis (RA) diagnosis. Mononeuritis multiplex is a peripheral neuropathy involving more than 2 separate nerve areas. A 62-year-old male patient was referred for left foot drop and polyarthritis of both hands and feet for 4 months. During evaluation, mononeuritis multiplex was detected on nerve conduction study and electromyography tests: vasculitis with neutrophil, eosinophil, and lymphocyte infiltration on peroneal nerve biopsy. A positive response to methacholin and bronchodilator was observed on the pulmonary function test. Radiologic tests showed peri-articular soft tissue swelling and osteopenia on both hand and foot. Marked peripheral eosinophilia, high RF, and positive perinuclear anti-neutrophil cytoplasmic antibody were detected on blood tests. Here, we report on a patient with overlap syndrome of CSS and RA with review of the relevant literature, from which a few references to overlap syndrome of CSS and RA were available.
Key Words: Churg-Strauss syndrome, Rheumatoid arthritis, Mononeuritis multiplex, Overlap syndrome
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