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Churg-Strauss Syndrome in Patients Receiving Montelukast as Treatment for Asthma
- Source :
- Chest. 117:708-713
- Publication Year :
- 2000
- Publisher :
- Elsevier BV, 2000.
-
Abstract
- Study objectives We previously reported eight patients who developed Churg-Strauss syndrome in association with zafirlukast treatment for asthma and postulated that the syndrome resulted from unmasking of a previously existing condition due to corticosteroid withdrawal and not from a direct drug effect. The availability of montelukast, a new leukotriene receptor antagonist with a different molecular structure, permitted us to test this hypothesis. Our goals were to ascertain whether the Churg-Strauss syndrome developed in patients taking montelukast and other novel asthma medications, and to describe potential mechanisms for the syndrome. Design Case series. Setting Outpatient and hospital practices of pulmonologists in the United States and Belgium. Patients Four adults (one man, three women) who received montelukast as treatment for asthma; two women who received salmeterol/fluticasone therapy, but not montelukast. Results Churg-Strauss syndrome developed in the four asthmatic patients who received montelukast. In each case, there was a long history of difficult-to-control asthma characterized by multiple exacerbations that had required frequent courses of oral systemic corticosteroids or high doses of inhaled corticosteroids for control. Two other asthmatics who received fluticasone and salmeterol but not montelukast therapy developed the same syndrome with tapering doses of oral or high doses of inhaled corticosteroids. Conclusions The occurrence of Churg-Strauss syndrome in asthmatic patients receiving leukotriene modifiers appears to be related to unmasking of an underlying vasculitic syndrome that is initially clinically recognized as moderate to severe asthma and treated with corticosteroids. Montelukast does not appear to directly cause the syndrome in these patients.
- Subjects :
- Adult
Cyclopropanes
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.drug_class
Acetates
Churg-Strauss Syndrome
Sulfides
Critical Care and Intensive Care Medicine
Diagnosis, Differential
Adrenal Cortex Hormones
Risk Factors
immune system diseases
hemic and lymphatic diseases
Internal medicine
Bronchodilator
medicine
Humans
Anti-Asthmatic Agents
Zafirlukast
Montelukast
Asthma
Fluticasone
Leukotriene
Leukotriene receptor
business.industry
Middle Aged
medicine.disease
respiratory tract diseases
Surgery
Quinolines
Leukotriene Antagonists
Drug Therapy, Combination
Female
Salmeterol
Cardiology and Cardiovascular Medicine
business
hormones, hormone substitutes, and hormone antagonists
medicine.drug
Subjects
Details
- ISSN :
- 00123692
- Volume :
- 117
- Database :
- OpenAIRE
- Journal :
- Chest
- Accession number :
- edsair.doi.dedup.....efba5b63a753ecadecdabd8c1d291316