Leukotriene receptor antagonists Churg-Strauss syndrome

Zafirlukast and montelukast are well tolerated. Zafirlukast increases plasma concentrations of warfarin and decreases the concentrations of theophylline and erythromycin. In rare cases, treatment of patients with CysLT receptor antagonists is associated with the development of Churg-Strauss syndrome, a condition marked by acute vasculitis, eosinophilia, and a worsening of pulmonary symptoms. Because these symptoms often appear when patients are given the leukotriene receptor antagonists when they are being weaned from oral corticosteroid therapy, it is not clear whether they are related to the action of the antagonists or are due to a sudden reduction in corticosteroid therapy. 

Leukotriene receptor antagonists and Churg-Strauss syndrome... 

Churg-Strauss syndrome has been reported in an 18-year-old woman taking cysteinyl leukotriene receptor antagonists and oral rokitamicin 400 mg bd for 10 days (2). 

Bibby S, Healy B, Steele R, Kumareswaran K, Nelson H, Beasley R. Association between leukotriene receptor antagonist therapy and Churg- Strauss syndrome an analysis of the FDA AERS database. Thorax 2010 65(2) 132-8. 

Keogh KA, Specks U. Churg-Strauss syndrome clinical presentation, antineutrophil cytoplasmic antibodies, and leukotriene receptor antagonists. Am J Med 2003 115(4) 284-290. 

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