Bai Pu, Xie Peitao
Inner Mongolia Medical University Ordos School of Clinical Medicine, Ordos, 017000, People's Republic of China.
Vasc Health Risk Manag. 2024 Dec 14;20:567-578. doi: 10.2147/VHRM.S489212. eCollection 2024.
To explore the clinical characteristics and treatment outcomes of intracerebral hemorrhage in eosinophilic granulomatosis with polyangiitis (EGPA).
We report an 18-year-old student of EGPA complicated with intracerebral hemorrhage. The laboratory tests showed a continuous increase in eosinophils. The CT of head and chest showed cerebral hemorrhage and pulmonary infiltration.
The patient received an intravenous infusion of methylprednisolone 1g/(kg·d) and cyclophosphamide for 3 days, followed by oral prednisone 1 mg/(kg·d).
At discharge, the patient's head and chest CT showed obvious absorption of intracranial hematoma and improvement of pulmonary infiltration. We reviewed 40 previously published cases of EGPA with intracerebral hemorrhage focusing on the clinical features and treatment of intracerebral hemorrhage caused by EGPA.
For the cases of EGPA complicated with intracerebral hemorrhage, we should timely differentiate diagnosis and recognition. Early diagnosis with aggressive immunosuppressive therapy can help improve the prognosis of patients EGPA with intracerebral hemorrhage. When a patient is affected by EGPA, it is essential to remain vigilant for signs of Central Nervous System involvement. The treatment with glucocorticoids and cyclophosphamide is effective in managing EGPA.
探讨嗜酸性肉芽肿性多血管炎（EGPA）合并脑出血的临床特征及治疗效果。
我们报告一名18岁的EGPA学生，并发脑出血。实验室检查显示嗜酸性粒细胞持续升高。头颅和胸部CT显示脑出血和肺部浸润。
患者接受静脉输注甲泼尼龙1g/（kg·d）和环磷酰胺3天，随后口服泼尼松1mg/（kg·d）。
出院时，患者的头颅和胸部CT显示颅内血肿明显吸收，肺部浸润改善。我们回顾了40例先前发表的EGPA合并脑出血的病例，重点关注EGPA所致脑出血的临床特征和治疗。
对于EGPA合并脑出血的病例，应及时进行鉴别诊断和识别。早期诊断并积极进行免疫抑制治疗有助于改善EGPA合并脑出血患者的预后。当患者患有EGPA时，必须对中枢神经系统受累的迹象保持警惕。糖皮质激素和环磷酰胺治疗对管理EGPA有效。
