Department of Neurology, Osaka City University Graduate School of Medicine, Japan.
Intern Med. 2022 Mar 15;61(6):891-895. doi: 10.2169/internalmedicine.7999-21. Epub 2021 Sep 4.
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.
嗜酸性肉芽肿伴多血管炎（EGPA）常伴有周围神经病，但中枢神经系统受累的报道相当罕见。本文报告了一例 EGPA 患者，最初表现为高嗜酸性粒细胞血症，后来发展为哮喘、嗜酸性中耳炎、鼻窦炎和出血性结肠炎。随后她出现了偏瘫。头部磁共振成像显示多发性脑梗死，伴有皮质下和蛛网膜下腔出血，位于双侧交界区。她被诊断为 EGPA 引起的中风，并成功地接受了口服泼尼松龙治疗。EGPA 中小脑动脉的炎症可能导致双侧交界区梗死，伴有皮质下和蛛网膜下腔出血。
