Rituximab in Churg-Strauss syndrome

Churg-Strauss Syndrome (CSS) is a small vessel systemic vasculitis, characterised by asthma, peripheral eosinophilia, neuropathy, pulmonary infiltrates, and sinus abnormalities. 1 Conventional treatment with corticosteroids and cyclophosphamide 2 controls disease activity; however, relapse is frequent and the treatment is toxic. Alternative treatments include plasma exchange, 3 interferon alfa, 4 and intravenous immunoglobulin. 5 B cell depletion with rituximab has proved effective in autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, and antineutrophil cytoplasmic antibody (ANCA) associated vasculitis. 6 We present two cases of patients with refractory CSS who were successfully treated with rituximab.