Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/63592
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Type: Journal article
Title: Diffuse bilateral orbital inflammation in Churg-Strauss Syndrome
Author: Pradeep, T.
Prabhakaran, V.
McNab, A.
Dodd, T.
Selva-Nayagam, D.
Citation: Ophthalmic Plastic and Reconstructive Surgery, 2010; 26(1):57-59
Publisher: Lippincott Williams & Wilkins
Issue Date: 2010
ISSN: 0740-9303
1537-2677
Statement of
Responsibility: 
Thanuja Gopal Pradeep, Venkatesh C. Prabhakaran, Alan McNab and Dinesh Selva
Abstract: A 33-year-old man was diagnosed with asthma and within 5 weeks developed bilateral periocular swelling. Examination revealed bilateral axial proptosis with conjunctival nodules. His blood tests revealed a positive p-antineutrophil cytoplasmic autoantibody with significant eosinophilia. MRI of the orbit showed enlarged extraocular muscles, lacrimal glands, and infiltrative changes in the orbital fat. Biopsy demonstrated granulomatous inflammation with eosinophil predominance. A diagnosis of diffuse bilateral inflammation in Churg-Strauss syndrome was made and the patient responded dramatically to prednisolone with resolution of systemic and orbital findings. The second case was a 72-year-old woman with a prolonged prodromal phase of asthma, paranasal sinus disease, and bilateral orbital involvement by a process consistent with reactive lymphoid hyperplasia on initial biopsy. Three years later she developed rapidly worsening orbital disease, marked peripheral eosinophilia, and orbital biopsy showed evidence of granulomatous inflammation with marked eosinophil infiltration and vasculitic changes, and a weakly positive antineutrophil cytoplasmic autoantibody. Hence, diffuse bilateral orbital inflammation occurring in the setting of asthma and peripheral eosinophilia should raise the possibility of Churg-Strauss syndrome and warrants biopsy as early institution of therapy can reduce both systemic and ophthalmic complications.
Keywords: Humans; Churg-Strauss Syndrome; Methotrexate; Prednisolone; Immunosuppressive Agents; Glucocorticoids; Tomography, X-Ray Computed; Drug Therapy, Combination; Adult; Aged; Female; Male; Functional Laterality; Orbital Cellulitis
Rights: © 2010 The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.
RMID: 0020100184
DOI: 10.1097/IOP.0b013e3181b8c84e
Appears in Collections:Opthalmology & Visual Sciences publications

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