Churg-Strauss syndrome with broad spectrum clinical presentations: a report of 3 cases.

The American College of Rheuma• tology that has suggested 6 criteria from which 4 are required for a diagnosis of CSS with 99.7% specificity and 85% sensitivity. The 6 criteria include: asthma, eosinophilia > 10%, paranasal sinusitis, vasculitis based on histology, and mononeuritis multiplex [4]. Vasculitis lesions of CSS on histological examination are not typically seen in biopsies and are not specific for CSS; at the same time their absence is not cause to reject a diagnosis of CSS [5]. It is important to differentiate CSS from other systemic vasculitis because of the association between start of treatment and CSS prognosis [6,7]. In the present study, we report 3 CSS cases with diverse clinical presentations to investigate if a clinical approach and history of the patient could be diagnostic for CSS without invasive procedures such as histological confirmation by biopsy. We also sought to assess whether the absence of leukocytosis and eosinophilia could allow a diagnosis of CSS to be rejected.