Autoimmune Vasculitis Causing Acute Bilateral Lower Limb Paralysis

Abstract

Autoimmune vasculitis is an autoimmune disease that causes various systemic symptoms, such as fever, fatigue, joint pain, and night sweats. Its clinical course depends on the severity of the inflammation, which can cause acute clinical progression of symptoms. Moreover, when the inflammation of the arteries occurs in the deeper parts of the body, a biopsy may be difficult to perform. Here, we report a case of autoimmune vasculitis in an elderly man who visited our hospital with a chief complaint of muscle pain and fever triggered by a rapid paralysis of both lower limbs. Autoimmune vasculitis can cause a variety of systemic symptoms depending on the size of involved arteries, and its clinical course depends on the severity of the inflammation. Prompt diagnosis and simultaneous treatment of symptoms, excluding other likely diseases, prevent the development of severe and long-term complications of autoimmune vasculitis.

Keywords: autoimmune vasculitis; eosinophilic granulomatosis with polyangiitis; granulomatosis with polyangiitis; japan; microscopic polyangiitis; older patient; paralysis; polyarteritis nodosa; rural.

Figure 1. A femoral magnetic resonance imaging scan (coronal plane) showing the bilateral hip and thigh muscles with a high signal (arrows).

Figure 2. A pelvic magnetic resonance imaging scan (coronal plane) showing high signals in the bilateral sciatic nerves (arrows)

Figure 3. An enhanced abdominal computed tomography scan (transverse plane) showing generalized edema of the periarterial lesions around the superior and inferior mesenteric arteries (arrows).

Figure 4. An enhanced abdominal computed tomography scan (transverse plane) showing effusions of pericardial and pleural fluid (white arrows)