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KMID : 1100320150320020127
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Yeungnam University Journal of Medicine
2015 Volume.32 No. 2 p.127 ~ p.131
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An overlap syndrome of Churg-Strauss syndrome and rheumatoid arthritis
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Bae Seung-Il
Jang Jong-Geol
Kim Hun-Tae
Ahn Hee-Yun
Kim Min-Jung
Kim Hyun-Je
Lee Choong-Ki
Hong Young-Hoon
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Abstract
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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.
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KEYWORD
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Churg-Strauss syndrome, Rheumatoid arthritis, Mononeuritis multiplex, Overlap syndrome
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