• Title/Summary/Keyword: Perinuclear-anti-neutrophil cytoplasmic antibody

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An overlap syndrome of Churg-Strauss syndrome and rheumatoid arthritis

  • Bae, Seung Il;Jang, Jong Geol;Kim, Hun Tae;Ahn, Hee Yun;Kim, Min Jung;Kim, Hyun Je;Lee, Choong Ki;Hong, Young Hoon
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.127-131
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    • 2015
  • Churg-Strauss syndrome (CSS) is a necrotizing vasculitis with extra-, peri-vascular eosinophilic infiltration. Chronic symmetric polyarthritis with the presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody are the mainstay of rheumatoid arthritis (RA) diagnosis. Mononeuritis multiplex is a peripheral neuropathy involving more than 2 separate nerve areas. A 62-year-old male patient was referred for left foot drop and polyarthritis of both hands and feet for 4 months. During evaluation, mononeuritis multiplex was detected on nerve conduction study and electromyography tests: vasculitis with neutrophil, eosinophil, and lymphocyte infiltration on peroneal nerve biopsy. A positive response to methacholin and bronchodilator was observed on the pulmonary function test. Radiologic tests showed peri-articular soft tissue swelling and osteopenia on both hand and foot. Marked peripheral eosinophilia, high RF, and positive perinuclear anti-neutrophil cytoplasmic antibody were detected on blood tests. Here, we report on a patient with overlap syndrome of CSS and RA with review of the relevant literature, from which a few references to overlap syndrome of CSS and RA were available.