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Case Report



Diagnosis of Churg-Strauss Syndrome at 23 Weeks Gestation: a case report

Oadi N. Shrateh, Areej Yaseen, Mashhour Naasan, Khalil Karim, Mohand Abulihya.




Abstract

Introduction. Eosinophilic granulomatosis with polyangiitis (EGPA), also known as
Churg Strauss syndrome (CCS) is an extremely rare diagnosis, and much less frequently in the childbearing period, particularly in association with pregnancy. This is thought to be due to several considerations including the paucity of the condition, with the mean age of diagnosis approximately 40s-50s and male gender tendency. The ambiguity and diversity of clinical manifestations result in delayed diagnosis, aggressive course and a high mortality rate.
Case report. We report a case of a 28-year-old Palestinian woman primigravida at 23 weeks gestation who was admitted to the hospital due to acute asthma exacerbation symptoms in association with markedly elevated eosinophilic count and rash. Diagnosis of Churg Strauss syndrome was established as the first reported case of the condition in Palestine and steroidal medication was initiated with unremarkable responsiveness to the regimen. The pregnancy was complicated with intrauterine fetal growth restriction (IUGR) which is terminated by Cesarean delivery of a healthy baby at 32.
Conclusion. There is no obvious mechanism by which this type of vasculitis affects the pregnancy and vice versa, it’s evident that the risk of obstetric complications for instance intrauterine fetal demise, miscarriage, premature rupture of membrane, and intrauterine fetal growth restriction (IUGR) - as in this case- is significantly escalated during the disease. This case also suggests that the disease process can be accelerated by the pregnancy.

Key words: eosinophilic granulomatosis with polyangiitis, Churg-Strauss syndrome, pregnancy, intrauterine fetal growth restriction






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