Churg-Strauss syndrome presenting with eosinophilic myocarditis: a diagnostic challenge

Abstract

Churg-Strauss syndrome (CSS) is an unusual disease that presents as systemic vasculitis and peripheral eosinophilia in patients with an atopic constitution. Cardiac involvement is unusual and often not prominent on initial presentation, but is an important cause of morbidity and mortality in patients with CSS. We report the case of a young woman with severe acute myocarditis. Coronary arteriography demonstrated extensive focal vasculopathy, consistent with coronary vasculitis, and myocardial biopsy showed eosinophilic myocarditis. This presentation led to an initial diagnosis of CSS in this patient and appropriate therapy resulted in a spectacular remission of disease activity.

Keywords: Churg–Strauss syndrome; Complete reversal of cardiac involvement; Coronary vasculitis; Eosinophilic myocarditis; Miocardite eosinofílica; Reversão completa do envolvimento cardíaco; Síndrome de Churg–Strauss; Vasculite coronária.