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Updated: Jul 8, 2026

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Microscopic Polyangiitis With a Twist: A Rare Case of CRAO and Brainstem Infarction

Govind Singh Mann1, Saurabh Nandwani1, Nitin Jain1

  • 1Department of Neurology, Sant Parmanand Hospital, Delhi, India.

Journal of Neuroimmunology
|July 12, 2025
PubMed

Insights

Microscopic polyangiitis (MPA), a rare autoimmune vasculitis, can cause central retinal artery occlusion (CRAO). Early diagnosis and immunosuppressive therapy are crucial for managing this rare vascular complication.

Area of Science:

  • Rheumatology
  • Ophthalmology
  • Neurology

Background:

  • Microscopic polyangiitis (MPA) is a rare autoimmune vasculitis affecting small blood vessels, often associated with anti-neutrophil cytoplasmic antibodies (ANCA).
  • Central retinal artery occlusion (CRAO) presents as sudden, painless vision loss, typically due to embolic or inflammatory processes.
  • The association between MPA and CRAO is infrequently documented in medical literature.

Observation:

  • This case report details a 50-year-old patient with a confirmed diagnosis of MPA.
  • The patient presented with central retinal artery occlusion (CRAO) and a brainstem infarct.

Findings:

  • The case highlights an uncommon presentation of MPA involving both ocular and neurological vascular events.
  • This unique case underscores the potential for MPA to manifest with severe vascular occlusions.

Implications:

  • Emphasizes the need for early recognition of atypical vascular manifestations in MPA patients.
  • Highlights the importance of multidisciplinary diagnostic strategies for systemic vasculitis.
  • Stresses the role of immunosuppressive therapies in managing MPA and its vascular complications.
Keywords:
AutoimmuneMononeuritis multiplexNeuropathyRetinal artery occlusionVasculitic infarctVasculitis

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