We and others have proposed that desensitisation, vaccination, or inhalation of antigens by asthmatic patients may trigger Churg-Strauss syndrome (CSS).1-4 Few observations of vasculitis occurring immediately after massive inhalation of a presumed antigen have been published.2 We describe here four patients who experienced acute onset of systemic vasculitis after massive antigen inhalation.
Case 1: Several hours after massively inhaling dark diesel fumes, a 55 year old man developed rapid onset dyspnoea, sinusitis, and high fever, which regressed with short term steroid treatment. After three months he complained of bilateral foot drop, which was found to be due to mononeuritis multiplex in the left peroneal nerve upon clinical examination. The erythrocyte sedimentation rate was 72 mm/1st h, white blood cell count was 16.12×109/l,3 with 1870 eosinophils, serum creatinine 170 µmol/l; proteinuria 0.7 g/day, and microscopic haematuria. Specific anti-myeloperoxidase perinuclear labelling antineutrophil cytoplasmic antibodies (ANCA) were detected (30 IU).
You can find the full text at this link.
My Analysis: We have a female patient on the WG discussion group who experienced these same symptoms when she inhaled dirt and fungus from the vent system (possibly asbestos, too). She worked in a school. The principal felt that the school district could save a lot of money if the vents were cleaned out by untrained workers. In the process, (she was a special ed teacher) the patient and her students inhaled a full dose of toxic fumes and substances through the vents.
It wasn’t too long that she began to have many of the same symptoms from the case history. She was diagnosed with WG, but not before she had been told by some of her doctors that she was a hypochondriac. I want to mention here, that many WG patients have the same story. Many first diagnosis for these patients was of mental illness rather than physical illness. It is a very scary.
Luckily for this patient, she was able to prove that her disease was specifically caused by this action of the school (and principal.) Many of us cannot prove what caused our disease. In fact, because we cannot prove who or what, we cannot hold that person or entity liable… and treating this disease and staying healthy is a constant process. Also very expensive.
If you would like to help us, please contact the Vasculitis Foundation. I have a link at the right of this blog under Vasculitis. We have found from talking to other WG patients with the disease that when WG is present in the family, there are also other autoimmune diseases present also. For instance, Rheumatoid Arthritis is usually found with WG. In my case, my aunt has Addison’s disease. Also, there is asthma in several members of my family.
We think that WG and other vasculitis diseases are more widespread than is commonly known.