Eosinophilic granulomatosis with polyangiitis presenting with multiple intracerebral haemorrhages - A case report

Eosinophilic granulomatosis with polyangiitis also known as Churgg-Strauss syndrome is a systemic multi system vasculitis. Neurological involvement is mostly in the form of peripheral nervous system disease. Central nervous system involvement is relatively uncommon with most cases being secondary to ischaemic infarctions. Intra cerebral haemorrhage is rare and is usually in the form of solitary haemorrhagic lesions. Multiple intra cerebral haemorrhages are exceptionally rare with only one case documented in medical literature. Here, we present the case of a middle aged male who presented to us with multiple intra cerebral haemorrhages, mono neuritis multiplex, renal and respiratory tract involvement and peripheral blood eosinophilia. Upon fulfilling the American College of Rheumatology criteria, he was diagnosed as an exceptionally rare case of EGPA with multiple intra cerebral haemorrhages. He was treated with intra venous corticosteroids and immune suppressants, and made a good recovery.