Treatment of Churg-Strauss syndrome with an inhaled corticosteroid after oral steroids discontinuation due to side effects.

Churg-Strauss syndrome is characterized by a history of asthma, peripheral blood and tissue eosinophilia, with a predilection to the lungs. In this article we present a case of a 35 years old patient admitted to the hospital as a case of severe asthma apparently complicated by bilateral pneumonia. After a transient improvement on antibiotics, the respiratory symptoms recurred one month later in an exacerbated form. The diagnosis of Churg-Strauss syndrome was established on a clinical basis and a long-term therapy with oral corticosteroids and cyclophosphamide was introduced. The treatment must have been withdrawn after a year, because of a whole range of adverse effects, even though there was a severe recurrence of symptoms during the therapy. A regimen of the inhaled corticosteroid ciclesonide was then started, which entirely prevented the recurrence of respiratory symptoms over a two year follow-up period.