Demographic and Clinical Characteristics Associated with Central Nervous System Hemorrhage in Patients with Eosinophilic Granulomatosis with Polyangiitis: A Case Report and Review of the Literature.

Abstract

To the Editor: Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis affecting the small- and medium-sized arteries. It is characterized by bronchial asthma often accompanied by pulmonary infiltrates, chronic sinusitis, nasal polyps, and peripheral blood eosinophilia, and occasionally followed by a multisystem vasculitic phase involving several organs. Neurological involvement occurs in 51%–86%, usually affecting the peripheral nerves. Conversely, the central nervous system (CNS) is seldom affected (< 10%). In these cases, cerebral ischemic infarction (∼80%) and diffuse encephalopathy (∼10%) have been by far the findings most frequently reported. Published data on EGPA with CNS hemorrhage are limited to anecdotal case reports1–10,11–20,21,22,23,24,25,26. We described a case of EGPA presenting with intracerebral hemorrhage (ICH) and did a comprehensive review of the literature. Ethics board approval was not required in accordance with the policy of our hospital. A 48-year-old man was admitted because of malaise, intermittent low-grade fever, and mild weight loss in … Address correspondence to Dr. J.M. Sabio, Servicio de Medicina Interna, 9th planta Hospital Universitario Virgen de las Nieves, Avda. Fuerzas Armadas No. 2, 18012 Granada, Spain. E-mail: jomasabio{at}gmail.com