Uchi Takahumi, Konno Shingo, Kihara Hideo, Matsushima Mari, Sugimoto Hideki, Oharaseki Toshiaki, Takahashi Kei, Fujioka Toshiki
Department of Neurology, Toho University Ohashi Medical Center, Tokyo, Japan.
Department of Pathology, Toho University Ohashi Medical Center, Tokyo, Japan.
Case Rep Neurol. 2022 Jul 11;14(2):314-319. doi: 10.1159/000525702. eCollection 2022 May-Aug.
A 55-year-old woman with a history of allergic sinusitis was being administered cyclosporine for ptosis and diplopia due to myasthenia gravis since age 46 years. She developed painful dysesthesia that began in her feet and later spread to her palms, leading to difficulty in walking. Eosinophils were markedly increased in the peripheral blood. Nerve conduction studies revealed mononeuritis multiplex. Nerve biopsy showed the infiltration of eosinophils in the superior neurovasculature. Based on these findings, eosinophilic granulomatous polyangiitis was diagnosed. Methylprednisolone pulse therapy was followed by oral prednisolone. Two weeks after treatment, the patient could do normal daily activities without assistance. In patients with myasthenia gravis having a history of allergic diseases, considering EGPA as a complication and monitoring prior changes in blood data are necessary for early detection before apparent tissue damage.
一名55岁女性，有过敏性鼻窦炎病史，自46岁起因重症肌无力接受环孢素治疗上睑下垂和复视。她出现了疼痛性感觉异常，始于足部，后来蔓延至手掌，导致行走困难。外周血嗜酸性粒细胞显著增多。神经传导研究显示为多发性单神经炎。神经活检显示嗜酸性粒细胞浸润于神经血管上部。基于这些发现，诊断为嗜酸性肉芽肿性多血管炎。给予甲泼尼龙冲击治疗，随后口服泼尼松龙。治疗两周后，患者无需协助即可进行正常日常活动。对于有过敏性疾病史的重症肌无力患者，将嗜酸性肉芽肿性多血管炎视为并发症并监测血液数据的先前变化对于在明显组织损伤之前进行早期检测是必要的。
