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a Department of
Pneumology, b Department of
Pathology, c University
Hospital Dr. Peset, Valencia, Spain
Correspondence to: Dr J Franco, Diputado Luis Lucía 19-5, E-46015 Valencia, Spain.
Received 6 January 1999; Returned to authors 26 February 1999; Revised version received 12 March 1999; Accepted for publication 16 March 1999
Antileukotriene drugs are new therapeutic agents that
have recently been approved for the treatment of asthma. Several cases of eosinophilic conditions including Churg-Strauss syndrome have been
reported to be associated with zafirlukast, a cysteinyl leukotriene type 1 receptor antagonist. So far no other leukotriene modifier has
been associated with the syndrome. The case history is presented of a
man with allergic rhinitis and asthma who had received intermittent pulse therapy with oral corticosteroids. Pulmonary eosinophilia developed while he was receiving treatment with montelukast, a chemically distinct cysteinyl leukotriene type 1 receptor antagonist. After discontinuation of montelukast therapy and administration of
systemic corticosteroids the patient's symptoms reversed rapidly and
there was prompt resolution of the pulmonary infiltrates. We believe
that cysteinyl leukotriene type 1 receptor antagonists are safe and
effective drugs for most patients with asthma but caution is needed for
those with more severe disease who require systemic corticosteroids,
especially if they show characteristics of the atypical allergic
diathesis seen in the prodromal phase of Churg-Strauss syndrome.
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