Yeungnam Univ J Med.  2015 Dec;32(2):127-131. 10.12701/yujm.2015.32.2.127.

An overlap syndrome of Churg-Strauss syndrome and rheumatoid arthritis

• Bae SI
• Jang JG
• Kim HT
• Ahn HY
• Kim MJ
• Kim HJ
• Lee CK
• Hong YH

• KMID: 2319914
• DOI: http://doi.org/10.12701/yujm.2015.32.2.127

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.

Keyword

Churg-Strauss syndrome; Rheumatoid arthritis; Mononeuritis multiplex; Overlap syndrome

MeSH Terms

Antibodies, Antineutrophil Cytoplasmic
Arthritis
Arthritis, Rheumatoid*
Biopsy
Bone Diseases, Metabolic
Churg-Strauss Syndrome*
Diagnosis
Electromyography
Eosinophilia
Eosinophils
Foot
Hand
Hematologic Tests
Humans
Lymphocytes
Male
Middle Aged
Mononeuropathies
Neural Conduction
Neutrophils
Peripheral Nervous System Diseases
Peroneal Nerve
Respiratory Function Tests
Rheumatoid Factor
Vasculitis
Antibodies, Antineutrophil Cytoplasmic
Rheumatoid Factor