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Published on: August 21, 2017
Microscopic polyangiitis presenting with peripheral and central neurological manifestations.
S Ben Sassi1, I Ben Ghorbel, H Mizouni
1Neurology Department, National Institute of Neurology, Tunis, Tunisia. bensassisam@yahoo.fr
Summary
Microscopic angiitis can rarely affect the brain and muscles, causing symptoms like mononeuritis multiplex and stroke. Early diagnosis and treatment are crucial for managing this rare vasculitis.
Area of Science:
- Neurology
- Rheumatology
- Pathology
Background:
- Peripheral neuropathy is a common complication of microscopic angiitis.
- Central nervous system and muscle involvement are rare but serious manifestations.
Observation:
- A 48-year-old man presented with mononeuritis multiplex, progressing to coma and cerebral hemorrhage.
- Laboratory tests showed inflammation, kidney dysfunction, and positive myeloperoxidase-antineutrophil cytoplasmic antibodies.
Findings:
- Neuromuscular biopsy confirmed small-vessel vasculitis (microscopic angiitis) with myositis and axonal loss.
- The patient experienced a massive cerebral hematoma leading to hemiplegia.
Implications:
- Microscopic angiitis should be considered in differential diagnoses for myositis and intracerebral hemorrhage.
- Prompt surgical intervention and immunosuppressive therapy led to a good outcome.
- Highlights the importance of considering rare neurological and muscular manifestations of vasculitis.
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