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A retrospective study of bronchial hyperresponsiveness in patients with asthma before the onset of Churg–Strauss syndrome

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Asthma is one of the most common clinical symptoms in Churg–Strauss syndrome (CSS). However, it is not known how lung function and bronchial hyperresponsiveness (BHR) prior to the development of CSS differs from asthmatics do not develop CSS. This retrospective cohort study was conducted to predict the onset of CSS and facilitate diagnosis in the early phase of the disease. We examined 24 pre-CSS asthmatic patients and 294 non-CSS asthmatic patients for clinical features, percent forced expiratory volume at 1 second (%FEV1), BHR to acetylcholine, and evaluated eosinophils (%) in the peripheral blood at their first hospital visit for asthma treatment. All of the 24 pre-CSS patients had adult-onset asthma. The asthma of 87.5% of pre-CSS patients at the first hospital visit before the onset of CSS was severe and was complicated by sinusitis. The eosinophils (%) in the peripheral blood was significantly higher than in non-CSS asthmatic patients. The %FEV1 in both the patients with severe asthma and the patients who developed CSS was lower than in patients with mild or moderate asthma. However, BHR in pre-CSS patients was significantly better than in non-CSS patients with severe asthma and was as mild as in patients with mild asthma. Patients who developed CSS had clinically severe asthma before the onset of CSS. The severity of their asthma was related to airflow limitation and eosinophilic inflammation in the peripheral blood, but not to BHR. These findings should prove useful in future early diagnosis and treatment of CSS.
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Keywords: Asthma; Churg–Strauss syndrome; bronchial hyperresponsiveness; eosinophilia; lung function; sinusitis

Document Type: Research Article

Affiliations: From the Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa, Japan

Publication date: 2007-05-01

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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