Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Mar 26;16(3):e56949.
doi: 10.7759/cureus.56949. eCollection 2024 Mar.

Eosinophilic Granulomatosis With Polyangiitis Presenting With Purpura, Mononeuritis Multiplex, and Cerebral Infarction

Aswinishree Bagavandoss  1 , Jency Kurian  1 , Samson O Oyibo  2 , Olugbenro O Akintade  3
Affiliations
Case Reports

Eosinophilic Granulomatosis With Polyangiitis Presenting With Purpura, Mononeuritis Multiplex, and Cerebral Infarction

Aswinishree Bagavandoss et al. Cureus. .

Abstract

We present a case of a 52-year-old woman who had transient speech impediment and progressive numbness, weakness, and a purpuric rash affecting her limbs, with severe joint pains. Because she had a chest infection two weeks prior, her clinical presentation gave rise to a suspicion of post-infective vasculitis or post-infective polyneuritis. Further investigation proved this to be eosinophilic granulomatosis with polyangiitis (EGPA) presenting with purpura, mononeuritis multiplex, and cerebral infarction. Treatment with glucocorticoids and cyclophosphamide led to rapid remission. This case highlights the potential difficulty in diagnosing EGPA because of its multiple clinical manifestations and emphasizes the importance of a thorough review of the past medical history.

Keywords: anca associated vasculitis; cerebral infarction; eosinophilic granulomatosis with polyangiitis (egpa); mononeuritis multiplex; purpura.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Purpuric rash over left hand and behind both thighs and knees
a) Purpuric rash over left hand. b) Purpuric rash behind both thighs and knees
Figure 2
Figure 2. Diffusion-weighted magnetic resonance imaging scan of the brain
Axial view demonstrating the subacute infarct in the right corona radiata (red arrow)
See this image and copyright information in PMC

References

    1. Evidence-based guideline for the diagnosis and management of eosinophilic granulomatosis with polyangiitis. Emmi G, Bettiol A, Gelain E, et al. Nat Rev Rheumatol. 2023;19:378–393. - PubMed
    1. Update on eosinophilic granulomatosis with polyangiitis. Furuta S, Iwamoto T, Nakajima H. Allergol Int. 2019;68:430–436. - PubMed
    1. Eosinophilic granulomatosis with polyangiitis: Understanding the disease and its management. Trivioli G, Terrier B, Vaglio A. Rheumatology (Oxford) 2020;59:84–94. - PubMed
    1. 2022 American College of Rheumatology/European Alliance of associations for rheumatology classification criteria for eosinophilic granulomatosis with polyangiitis. Grayson PC, Ponte C, Suppiah R, et al. Ann Rheum Dis. 2022;81:309–314. - PubMed
    1. Clinical manifestations and long-term outcomes of eosinophilic granulomatosis with polyangiitis in North America. Doubelt I, Cuthbertson D, Carette S, et al. ACR Open Rheumatol. 2021;3:404–412. - PMC - PubMed

Publication types

LinkOut - more resources