A Rare Case of Eosinophilic Granulomatosis with Polyangiitis Presenting as Ischemic Stroke and Splenic Infarction

Eosinophilic Granulomatosis with Polyangiitis (EGPA) is a group of systemic disorders characterized by inflammation of blood vessels and eosinophilia. Simultaneous brain and splenic infarcts are extremely rare in patients with EGPA.

We report a case of a 61-year-old male with a history of asthma and sinusitis who presented with paresthesia and purpura in the lower extremities. Eosinophilia and positive Myeloperoxidase-anti-neutrophil cytoplasmic antibody were present and the diagnosis of EGPA was confirmed. Multiple bilateral cerebral and cerebellar infarcts and splenic infarction were detected. Although there was evidence of myocarditis, no cardiac thrombus was detected. Immunosuppressive and anticoagulation therapy were provided. The patient was fully recovered.

EGPA can present as splenic infarction and ischemic stroke. Prompt diagnosis and treatment with anticoagulant and immunosuppressive agents may lead to good prognosis.