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Cerebral Infarction and Myalgia in a 75-year-old Man with Eosinophilic Granulomatosis with Polyangiitis

Yuki Ueta1, Yuki Akiba1, Jun Yamazaki1

  • 1Department of Neurology, Tokyo Medical University Hachioji Medical Center, Japan.

Internal Medicine (Tokyo, Japan)
|August 8, 2020
PubMed

Insights

Eosinophilic granulomatosis with polyangiitis (EGPA), a rare vasculitis, can cause stroke. This case highlights EGPA as a potential cause of cerebral infarction in patients with fever, myalgia, and eosinophilia.

Area of Science:

  • Rheumatology
  • Neurology
  • Pathology

Background:

  • Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis affecting small to medium-sized blood vessels.
  • EGPA typically presents with asthma, allergic rhinitis, and eosinophilia, but atypical presentations occur.

Observation:

  • A 75-year-old man presented with right-sided hemiplegia and cerebral infarction.
  • His symptoms included myalgia and high fever, with no prior history of asthma or allergic rhinitis.
  • Diagnostic findings included eosinophilia, sinusitis on MRI, and characteristic muscle pathology.

Findings:

  • The patient was diagnosed with Eosinophilic granulomatosis with polyangiitis (EGPA).
  • Rapid improvement in hemiplegia was observed following corticosteroid treatment.

Implications:

  • This case underscores the importance of considering EGPA in the differential diagnosis of cerebral infarction, particularly in patients presenting with myalgia and eosinophilia.
  • Early recognition and treatment of EGPA can lead to favorable neurological outcomes.
Keywords:
Churg-Strauss syndromecerebral infarctioncorticosteroid therapyeosinophilic granulomatosis with polyangiitis (EGPA)muscle biopsymyalgia

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