Patients with asthma on therapy with SINGULAIR may present with systemic eosinophilia , sometimes presenting with clinical features of vasculitis consistent with Churg-Strauss syndrome , a condition which is often treated with systemic corticosteroid therapy. These events have been sometimes associated with the reduction of oral corticosteroid therapy. Physicians should be alert to eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy presenting in their patients. A causal association between SINGULAIR and these underlying conditions has not been established [see ADVERSE REACTIONS ].
Family history is a risk factor for asthma, with many different genes being implicated.  If one identical twin is affected, the probability of the other having the disease is approximately 25%.  By the end of 2005, 25 genes had been associated with asthma in six or more separate populations, including GSTM1 , IL10 , CTLA-4 , SPINK5 , LTC4S , IL4R and ADAM33 , among others.  Many of these genes are related to the immune system or modulating inflammation. Even among this list of genes supported by highly replicated studies, results have not been consistent among all populations tested.  In 2006 over 100 genes were associated with asthma in one genetic association study alone;  more continue to be found.