嗜酸性肉芽肿性多血管炎致缺血性脑卒中与脾梗死 1 例罕见病例报告
A Rare Case of Eosinophilic Granulomatosis with Polyangiitis Presenting as Ischemic Stroke and Splenic Infarction.
机构信息
Department of Cardiology, Handa City Hospital.
Department of Neurosurgery, Handa City Hospital, 2-29 Toyo-cho, Handa, Aichi, JAPAN 4758599.
出版信息
J Stroke Cerebrovasc Dis. 2021 Mar;30(3):105539. doi: 10.1016/j.jstrokecerebrovasdis.2020.105539. Epub 2020 Dec 14.
BACKGROUND
Eosinophilic Granulomatosis with Polyangiitis (EGPA) is a group of systemic disorders characterized by inflammation of blood vessels and eosinophilia. Simultaneous brain and splenic infarcts are extremely rare in patients with EGPA.
CASE DESCRIPTION
We report a case of a 61-year-old male with a history of asthma and sinusitis who presented with paresthesia and purpura in the lower extremities. Eosinophilia and positive Myeloperoxidase-anti-neutrophil cytoplasmic antibody were present and the diagnosis of EGPA was confirmed. Multiple bilateral cerebral and cerebellar infarcts and splenic infarction were detected. Although there was evidence of myocarditis, no cardiac thrombus was detected. Immunosuppressive and anticoagulation therapy were provided. The patient was fully recovered.
CONCLUSIONS
EGPA can present as splenic infarction and ischemic stroke. Prompt diagnosis and treatment with anticoagulant and immunosuppressive agents may lead to good prognosis.
背景
嗜酸性肉芽肿性多血管炎（EGPA）是一组以血管炎症和嗜酸性粒细胞增多为特征的全身性疾病。同时发生脑和脾梗死在 EGPA 患者中极为罕见。
病例描述
我们报告了一例 61 岁男性病例，该患者有哮喘和鼻窦炎病史，表现为下肢感觉异常和紫癜。存在嗜酸性粒细胞增多和髓过氧化物酶-抗中性粒细胞胞质抗体阳性，确诊为 EGPA。检测到多处双侧大脑和小脑梗死和脾梗死。虽然有心肌炎的证据，但未检测到心脏血栓。给予免疫抑制和抗凝治疗。患者完全康复。
结论
EGPA 可表现为脾梗死和缺血性脑卒中。及时诊断和抗凝及免疫抑制剂治疗可能带来良好的预后。
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