A Case of Churg-Strauss Syndrome with Diffuse Alveolar Hemorrhage Presenting as Acute Acalculous Cholecystitis.

Kim, Ji Eun; Kim, Ki Uk; Park, Hye Kyung; Jeon, Doo Soo; Kim, Yun Sung; Lee, Min Ki; Park, Soon Kew

doi:2009.66.3.225

Tuberc Respir Dis > Volume 66(3); 2009 > Article

Case Report

Tuberculosis and Respiratory Diseases 2009;66(3):225-229.
DOI: https://doi.org/10.4046/trd.2009.66.3.225 Published online March 1, 2009.

A Case of Churg-Strauss Syndrome with Diffuse Alveolar Hemorrhage Presenting as Acute Acalculous Cholecystitis.

Ji Eun Kim, Ki Uk Kim, Hye Kyung Park, Doo Soo Jeon, Yun Sung Kim, Min Ki Lee, Soon Kew Park

Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea. parkhk@pusan.ac.kr

Abstract

Churg-Strauss syndrome (CSS) is a disorder that is characterized by asthma, hypereosinophilia and systemic vasculitis affecting a number of organs. The manifestations of acute cholecystitis and diffuse alveolar hemorrhage are rarely reported in CSS. A 22-year-old woman with bronchial asthma visited our hospital complaining of right upper quadrant pain with a sudden onset. The abdominal computed tomography (CT) scan revealed gall bladder edema consistent with acute cholecystitis. On the initial evaluation, marked hypereosinophilia was observed in the peripheral blood smear. The nerve conduction velocity measurements and a skin biopsy performed to confirm the organ involvement of disease indicated typical mononeuritis multiplex and necrotizing vasculitis, respectively, which was complicated with CSS. On the 12th hospital day, ground glass opacity and consolidations were newly developed on both lung fields. The bronchoalveolar lavage (BAL) fluid showed increasing bloody return in sequential aliquots that were characteristic of a diffuse alveolar hemorrhage. We report a case of CSS with acute cholecystitis and diffuse alveolar hemorrhage.

Key Words: Churg-Strauss syndrome, Acute cholecystitis, Diffuse alveolar hemorrhage