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Is this an exacerbation of asthma? A cautionary tale
  1. Bharat Sidhu1,
  2. Uttam Nanda2,
  3. Shahab Abbas2
  1. 1Department of General Medicine, NHS, Birmingham, West Midlands, UK
  2. 2Department of Respiratory, Queens Hospital Burton, Birmingham, UK
  1. Correspondence to Dr Bharat Sidhu, b.sidhu2{at}


Asthma exacerbations are a fairly common presentation to emergency departments. However, a careful history, clinical examination and interpretation of investigations may uncover a more serious pathology. We present an interesting case of a 44-year-old man with symptoms suggestive of an asthma exacerbation, who was found to have Churg-Strauss vasculitis/eosinophilic granulomatosis with polyangitis. He had clinical features of a vasculitis, ECG changes and a troponin T level of 7562 ng/L. Renal biopsy confirmed Churg-Strauss vasculitis. Cardiac involvement in Churg-Strauss Syndrome (CSS) is one of the leading causes of mortality. We describe the successful diagnosis and management of a patient with CSS.

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