Multiple Cerebral Infarctions Accompanied by Subcortical and Subarachnoid Hemorrhaging in Bilateral Border Zone Areas in a Patient with Eosinophilic Granulomatosis with Polyangiitis

Eosinophilic granulomatosis with polyangiitis (EGPA) is often associated with peripheral neuropathy, but reports of central nervous system involvement are quite rare. We herein report a patient with EGPA first identified as having hypereosinophilia who later developed asthma, eosinophilic otitis med...

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Bibliographic Details
Published in:Internal Medicine 2022/03/15, Vol.61(6), pp.891-895
Main Authors: Mino, Toshikazu, Sakaguchi, Hiroka, Hasegawa, Itsuki, Takeda, Akitoshi, Yoshizaki, Takahito, Abe, Takato, Itoh, Yoshiaki
Format: Article
Language:English
Subjects:
Arteries
Asthma
border zone infarction
Case Report
Central nervous system
Cerebral infarction
Cerebral Infarction - complications
Cerebral Infarction - etiology
Churg-Strauss Syndrome - complications
Churg-Strauss Syndrome - diagnosis
Colitis
EGPA
Eosinophilia - complications
Eosinophilia - diagnostic imaging
eosinophilic granulomatosis with polyangiitis
Female
Granulomatosis
Granulomatosis with Polyangiitis - complications
Granulomatosis with Polyangiitis - diagnostic imaging
Hemorrhage
Humans
Internal medicine
Leukocytes (eosinophilic)
Magnetic resonance imaging
Otitis media
Paresis
Peripheral neuropathy
Prednisolone
Sinusitis
Subarachnoid Hemorrhage - complications
Subarachnoid Hemorrhage - diagnostic imaging
subarachnoid hemorrhaging
subcortical hemorrhaging
Twin plants
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Summary:Eosinophilic granulomatosis with polyangiitis (EGPA) is often associated with peripheral neuropathy, but reports of central nervous system involvement are quite rare. We herein report a patient with EGPA first identified as having hypereosinophilia who later developed asthma, eosinophilic otitis media, sinusitis, and hemorrhagic colitis. She subsequently developed hemiparesis. Head magnetic resonance imaging revealed multiple cerebral infarctions with subcortical and subarachnoid hemorrhaging colocalized at the bilateral border zone areas. She was diagnosed with EGPA-induced stroke and successfully treated with oral prednisolone. Inflammation in the small cerebral arteries in EGPA may induce bilateral border zone infarction with colocalizing subcortical and subarachnoid hemorrhaging.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.7999-21