Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Churg-Strauss syndrome is suggested when the symptoms described above occur in a patient with a history of asthma.
Abnormalities of the lungs, skin, and nerves might be noted by the
doctor during the examination. Blood pressure can be elevated.
Blood examination generally shows elevated levels of an uncommon
white blood cell, called an eosinophil, and other white blood cells are
also elevated in number.
Kidney function blood tests and urinalysis can be abnormal when the kidneys are affected (which is not common).
If the lungs are inflamed, the chest x-ray
image or CT scan of the chest can demonstrate areas of inflammation.
The ultimate test for the diagnosis is a biopsy of involved tissue, which demonstrates a characteristic pattern
of inflammation visible under a microscope. Eosinophil are also seen accumulated in the abnormal tissue.
How is Churg-Strauss syndrome treated?
The treatment of patients with Churg-Strauss syndrome is directed
toward both immediately quieting the inflammation of the blood
vessels (vasculitis) and suppressing the immune system. Treatment
usually includes high doses of cortisone-related medication (such as
prednisone or prednisolone)
to calm the inflammation and suppression of the active immune system with cyclophosphamide
(Cytoxan).
Traditionally, cyclophosphamide has been given for a year or more in patients with Churg-Strauss syndrome.
In a research study, Churg-Strauss syndrome patients did equally well if treated with cyclophosphamide for 6 or for 12 months.
This study suggests that doctors might now be able to recommend a shorter (and, therefore, less toxic) course of Cytoxan for patients with
Churg-Strauss syndrome.
Vasculitis is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.
Relapsing polychondritis is an uncommon, chronic disorder of the cartilage that is characterized by recurrent episodes of inflammation of the cartilage of various tissues of the body. Tissues containing cartilage that can become inflamed include the ears, nose, joints, spine, and windpipe (trachea). Tissues that have a biochemical makeup similar to that of cartilage such as the eyes, heart, and blood vessels, can also be affected. Nonsteroidal antiinflammatory medications (NSAIDs) is used as treatment for mild cases of the disease. Steroid-related medications also are usually required.
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