DEAR DR. GOTT:
I was diagnosed with eosinophilic pneumonia about 12 years ago. I was put on a high dose of prednisone and then was tapered off it. I now have asthma and am on prednisone again as well as an albuterol inhaler. Whenever I have an asthma attack, my doctor increases the prednisone dose and then tapers me back down.
My pulmonologist (lung doctor) now tells me I have Churg-Strauss, however, I don’t have any symptoms of it. I have had three blood tests taken but all were negative. Can you tell me anything about this disorder?
DEAR READER:
I will do my best. Churg-Strauss syndrome is one in which blood vessels become inflamed. It is therefore, both a pulmonary disorder as well as a form of vasculitis (which simply means blood vessel inflammation).
As for your statement that you do not have any symptoms of this disorder, I must disagree. Asthma is the most common sign of Churg-Strauss, as are abnormally high (10% or higher) levels of eosinophils, pulmonary infiltrates that move or come and go, a history of acute or chronic sinus pain, damage to one or more nerve groups, and extravascular eosinophils (present outside the blood vessels).
You have already had eosinophilic pneumonia and continue to have problems with asthma. Without knowing more of your medical history and tests, I cannot determine if you meet any more of the criteria (symptoms) that would backup the diagnosis of Churg-Strauss. Most pulmonologists feel confident in giving this diagnosis if a patient meets four of the criteria but others may need only two or three.
You say you have had three negative blood tests for this disorder. Have you had any lung biopsies or imaging studies such as chest X-rays or MRIs? What makes your specialist feel confident about giving your this diagnosis?
I urge you to speak to him or her and ask why they feel you have Churg-Strauss. There is no cure but they may have treatment options in mind. Since you are already using corticosteroids (prednisone), perhaps other immunosuppressive medications may be considered.
If you would like to learn more about this condition I recommend you review an article from the Mayo Clinic website, http://www.mayoclinic.com/health/churg-strauss-syndrome/DS00855. As I have often said in the past, the Mayo Clinic does an excellent job of providing patients with easy-to-understand material about a wide variety of medical conditions.
The information provided should answer some questions you have and allow you to ask more specific questions of your physician about diagnosis, testing and treatment. An informed patient is often the best patient. It is still vital to follow the doctor’s orders as he or she knows your case best, but by knowing what to ask you can get the best help.
To give you related information, I am sending you a copy of my Health Report “Pulmonary Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
About Dr. Gott