https://orcid.org/0000-0001-5324-2968
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Yumika Saito, Toshiyuki Watanabe, Toshiyuki Hattori, Satoshi Jodo, Intracranial vasculitis in eosinophilic granulomatosis with polyangiitis, Rheumatology, Volume 57, Issue 12, December 2018, Page 2253, https://doi.org/10.1093/rheumatology/key178
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A 59-year-old man with allergic asthma and sinusitis was admitted to the referring hospital with complaints of high fever, paraesthesia in the left foot and disturbance of consciousness. Laboratory tests demonstrated eosinophilia, positivity for MPO-ANCA, haematuria and proteinuria. Brain MRI, performed 2 days before admission to our hospital, revealed abnormal high-signal-intensity lesions indicating multiple cerebral infarctions, whereas brain magnetic resonance angiography (MRA) revealed no abnormal findings (Fig. 1A). Renal biopsy showed pauci-immune necrotizing glomerulonephritis. After admission, the disturbance of consciousness worsened, with new-onset disorientation. Therefore, brain MRI and MRA were repeated on hospital day 5, exhibiting cerebral infarction deterioration and multiple stenoses of the intracranial arteries with decreased intensity levels, respectively (Fig. 1B). The patient was diagnosed with eosinophilic granulomatosis with polyangiitis involving rapidly progressive intracranial arteritis.
He was treated using glucocorticoid, CYC and cilostazol. Subsequently, brain MRI and MRA examinations were repeated on hospital day 18; the former showed no additional cerebral infarctions and the latter revealed intracranial vasculitis improvement (Fig. 1C).
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