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Treatments and drugs
By Mayo Clinic staffThere's no cure for Churg-Strauss syndrome, but certain medications may help even people with serious symptoms achieve remission. A good outcome and a reduced risk of complications from both the disease and its treatment are more likely when Churg-Strauss syndrome is diagnosed and treated early.
Medications used to treat Churg-Strauss syndrome include:
- Corticosteroids. Prednisone is the most commonly prescribed drug for Churg-Strauss syndrome. Your doctor may prescribe a high dose of corticosteroids or a boost in your current dose of corticosteroids to get your symptoms under control as soon as possible. But because high doses of corticosteroids can cause serious side effects, including bone loss, high blood sugar, cataracts and hard-to-treat infections, your doctor will decrease the dose gradually until you're taking the smallest amount that will keep your disease under control. Even lower doses taken for extended periods can cause side effects, however.
- Other immunosuppressive drugs. For people with mild symptoms, a corticosteroid alone may be enough. Other people may require another immunosuppressive drug, such as cyclophosphamide (Cytoxan), azathioprine (Azasan, Imuran) or methotrexate (Rheumatrex, Trexall), to reduce the body's immune reaction still further. Because these drugs impair your body's ability to fight off infection and can cause other serious side effects, your condition will be closely monitored while you're taking them.
- Intravenous immunoglobulin (IVIg). Given as a monthly infusion, IVIg is the most benign of the treatments used for Churg-Strauss syndrome. The most common side effects are flu-like symptoms that usually last just a day or so. IVIg has two major drawbacks, however: It's very expensive, and it isn't universally effective. IVIg isn't considered a first-line treatment for Churg-Strauss syndrome, but studies have shown that it can be helpful for people who don't respond to other medications.
Because of the possible connection between montelukast and Churg-Strauss syndrome, your doctor will likely take you off this medication to see if your signs and symptoms improve.
Although drug therapy can relieve symptoms of Churg-Strauss syndrome — and send the disease into remission — relapses are common.
References
- Baldini C, et al. Clinical manifestations and treatment of Churg-Strauss syndrome. Rheumatic Disease Clinics of North America. 2010;36:527.
- Lee K, et al. Churg-Strauss syndrome. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05610-6..00012-3--sc0165&isbn=978-0-323-05610-6&sid=1068342455&type=bookPage§ionEid=4-u1.0-B978-0-323-05610-6..00012-3--sc0165&uniqId=222493850-3#4-u1.0-B978-0-323-05610-6..00012-3--sc0165. Accessed Oct. 12, 2010.
- Sneller MC, et al. Churg-Strauss syndrome. In: Adkinson NF, et al. Middleton's Allergy: Principles and Practice. 7th ed. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05659-5..00054-1--cesec15&isbn=978-0-323-05659-5&sid=1068342455&type=bookPage§ionEid=4-u1.0-B978-0-323-05659-5..00054-1--cesec15&uniqId=222493850-3#4-u1.0-B978-0-323-05659-5..00054-1--cesec15. Accessed Oct. 12, 2010.
- King TE Jr. Clinical features and diagnosis of Churg-Strauss syndrome (allergic granulomatosis and angiitis). http://www.uptodate.com/home/index.html. Accessed Oct. 12, 2010.
- King TE Jr. Epidemiology, pathogenesis, and pathology of Churg-Strauss syndrome (allergic granulomatosis and angiitis). http://www.uptodate.com/home/index.html. Accessed Oct. 12, 2010.
- King TE Jr. Treatment and prognosis of Churg-Strauss syndrome (allergic granulomatosis and angiitis). http://www.uptodate.com/home/index.html. Accessed Oct. 12, 2010.
- Glucocorticoid-induced osteoporosis. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/gi-osteoporosis.asp. Accessed Oct. 12, 2010.
- Cannon GW. Immunosuppressing drugs including corticosteroids. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/225194068-7/1078137300/1492/151.html#4-u1.0-B978-1-4160-2805-5..50038-0_1384. Accessed Nov. 2, 2010.
- Dietary supplement fact sheet: Vitamin D. National Institutes of Health. http://ods.od.nih.gov/factsheets/vitamind.asp. Accessed Oct. 12, 2010.
- Rosenow E (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 19, 2010.
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