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Although abdominal complications are occasionally reported in the Churg-Strauss syndrome (CSS), bowel perforations, cholecystitis, eosinophilic peritonitis, and oophoritis are very unusual1–8 and normally resolve after immunosuppressive treatment. We report the case of a patient with CSS with these complications, which was fatal despite proper treatment.
A 64 year old woman with a 13 year history of urticaria, recurrent rhinitis, and asthma was admitted for abdominal pain. An increasing peripheral eosinophilia rising from 1% to 22% in the past five years was detected. Two years before hospital admission an extensive urticariform erythema developed. An abdominal ultrasonography performed during an asthmatic exacerbation when she had no abdominal pain disclosed a thick-walled gall bladder with no echogenic contents. An excised nasal polyp showed polypoid hyperplasia with many eosinophils.
Two and six weeks later she was readmitted owing to right upper quadrant pain. The leucocyte count was 1×1010/l with 34% eosinophils. Abdominal ultrasonography and computed tomography (CT) …