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Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome

Eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs) which commonly affects the peripheral nervous system. A 38-year-old female with a history of asthma presented with a 2-week history of bilateral lower extre...

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Autores principales: Camara-Lemarroy, Carlos R., Infante-Valenzuela, Adrian, Villareal-Montemayor, Hector J., Soto-Rincon, Carlos A., Davila-Olalde, Javier A., Villareal-Velazquez, Hector J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493297/
https://www.ncbi.nlm.nih.gov/pubmed/26199772
http://dx.doi.org/10.1155/2015/981439
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author Camara-Lemarroy, Carlos R.
Infante-Valenzuela, Adrian
Villareal-Montemayor, Hector J.
Soto-Rincon, Carlos A.
Davila-Olalde, Javier A.
Villareal-Velazquez, Hector J.
author_facet Camara-Lemarroy, Carlos R.
Infante-Valenzuela, Adrian
Villareal-Montemayor, Hector J.
Soto-Rincon, Carlos A.
Davila-Olalde, Javier A.
Villareal-Velazquez, Hector J.
author_sort Camara-Lemarroy, Carlos R.
collection PubMed
description Eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs) which commonly affects the peripheral nervous system. A 38-year-old female with a history of asthma presented with a 2-week history of bilateral lower extremity paresthesias that progressed to symmetric ascending paralysis. Nerve conduction studies could not rule out Guillain-Barre syndrome (GBS) and plasmapheresis was considered. Her blood work revealed marked eosinophilia (>50%), she had purpuric lesions in her legs, and a head magnetic resonance image showed evidence of pansinusitis. Coupled with a history of asthma we suspected EGPA-associated neuropathy and started steroid treatment. The patient showed rapid and significant improvement. ANCAs were later reported positive. ANCA-associated vasculitides present most often as mononeuritis multiplex, but they can mimic GBS and should always be considered in the differential diagnosis, since the treatment strategies for these conditions are radically different.
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spelling pubmed-44932972015-07-21 Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome Camara-Lemarroy, Carlos R. Infante-Valenzuela, Adrian Villareal-Montemayor, Hector J. Soto-Rincon, Carlos A. Davila-Olalde, Javier A. Villareal-Velazquez, Hector J. Case Rep Neurol Med Case Report Eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs) which commonly affects the peripheral nervous system. A 38-year-old female with a history of asthma presented with a 2-week history of bilateral lower extremity paresthesias that progressed to symmetric ascending paralysis. Nerve conduction studies could not rule out Guillain-Barre syndrome (GBS) and plasmapheresis was considered. Her blood work revealed marked eosinophilia (>50%), she had purpuric lesions in her legs, and a head magnetic resonance image showed evidence of pansinusitis. Coupled with a history of asthma we suspected EGPA-associated neuropathy and started steroid treatment. The patient showed rapid and significant improvement. ANCAs were later reported positive. ANCA-associated vasculitides present most often as mononeuritis multiplex, but they can mimic GBS and should always be considered in the differential diagnosis, since the treatment strategies for these conditions are radically different. Hindawi Publishing Corporation 2015 2015-06-23 /pmc/articles/PMC4493297/ /pubmed/26199772 http://dx.doi.org/10.1155/2015/981439 Text en Copyright © 2015 Carlos R. Camara-Lemarroy et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Camara-Lemarroy, Carlos R.
Infante-Valenzuela, Adrian
Villareal-Montemayor, Hector J.
Soto-Rincon, Carlos A.
Davila-Olalde, Javier A.
Villareal-Velazquez, Hector J.
Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome
title Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome
title_full Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome
title_fullStr Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome
title_full_unstemmed Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome
title_short Eosinophilic Granulomatosis with Polyangiitis Presenting as Acute Polyneuropathy Mimicking Guillain-Barre Syndrome
title_sort eosinophilic granulomatosis with polyangiitis presenting as acute polyneuropathy mimicking guillain-barre syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493297/
https://www.ncbi.nlm.nih.gov/pubmed/26199772
http://dx.doi.org/10.1155/2015/981439
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