Key result
Corticosteroids immediately resolve symptoms and normalize troponin and eosinophils in a Churg-Strauss syndrome patient.
Why the study?
Persistently elevated troponin levels with normal ischemic work-up can create a diagnostic dilemma, particularly when associated with eosinophilia and multi-organ involvement.
Case Report (n=1)
Churg-Strauss syndrome should be considered in the differential diagnosis of patients with eosinophilia and elevated troponins, as early corticosteroid treatment can resolve symptoms and normalize cardiac markers.
Answers are grounded in this paper and cite their sources.
Supports considering Churg-Strauss in eosinophilia with troponin elevation; case report leaves open need for prospective validation.
In a patient with persistently elevated troponin levels but normal ischemic work-up, a diagnostic dilemma can ensue. This is the case of a 65-year-old woman whose only cardiac risk factor was age. She presented repeatedly with chest pain, elevated troponins, and consistently elevated eosinophil levels until the fourth admission when she presented with multi-organ abnormalities including asthma and vasculitis that led to the diagnosis of Churg-Strauss syndrome (CSS). Initiation of corticosteroids immediately resolved all of her presenting symptoms; troponin and eosinophil levels quickly normalized. Eosinophilia from CSS can lead to multi-organ damage including the heart. Therefore, one must consider CSS in the differential of eosinophilia as early detection and treatment may be critical in decreasing morbidity and mortality.
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Zaky et al. (2005) conducted a case report in Churg-Strauss syndrome (n=1). Corticosteroids was evaluated on Resolution of symptoms and normalization of troponin and eosinophil levels. Initiation of corticosteroids immediately resolved presenting symptoms and normalized troponin and eosinophil levels in a patient with Churg-Strauss syndrome.
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