Myasthenia Gravis Complicated by Eosinophilic Granulomatosis with Polyangiitis: A Case Report
A 55-year-old woman with a history of allergic sinusitis was being administered cyclosporine for ptosis and diplopia due to myasthenia gravis since age 46 years. She developed painful dysesthesia that began in her feet and later spread to her palms, leading to difficulty in walking. Eosinophils were...
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| Veröffentlicht in: | Case Reports in Neurology 2022-07, Vol.14 (2), p.314-319 |
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| creator | Uchi, Takahumi Konno, Shingo Kihara, Hideo Matsushima, Mari Sugimoto, Hideki Oharaseki, Toshiaki Takahashi, Kei Fujioka, Toshiki |
| description | A 55-year-old woman with a history of allergic sinusitis was being administered cyclosporine for ptosis and diplopia due to myasthenia gravis since age 46 years. She developed painful dysesthesia that began in her feet and later spread to her palms, leading to difficulty in walking. Eosinophils were markedly increased in the peripheral blood. Nerve conduction studies revealed mononeuritis multiplex. Nerve biopsy showed the infiltration of eosinophils in the superior neurovasculature. Based on these findings, eosinophilic granulomatous polyangiitis was diagnosed. Methylprednisolone pulse therapy was followed by oral prednisolone. Two weeks after treatment, the patient could do normal daily activities without assistance. In patients with myasthenia gravis having a history of allergic diseases, considering EGPA as a complication and monitoring prior changes in blood data are necessary for early detection before apparent tissue damage. |
| doi_str_mv | 10.1159/000525702 |
| format | Article |
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She developed painful dysesthesia that began in her feet and later spread to her palms, leading to difficulty in walking. Eosinophils were markedly increased in the peripheral blood. Nerve conduction studies revealed mononeuritis multiplex. Nerve biopsy showed the infiltration of eosinophils in the superior neurovasculature. Based on these findings, eosinophilic granulomatous polyangiitis was diagnosed. Methylprednisolone pulse therapy was followed by oral prednisolone. Two weeks after treatment, the patient could do normal daily activities without assistance. In patients with myasthenia gravis having a history of allergic diseases, considering EGPA as a complication and monitoring prior changes in blood data are necessary for early detection before apparent tissue damage.</description><identifier>ISSN: 1662-680X</identifier><identifier>EISSN: 1662-680X</identifier><identifier>DOI: 10.1159/000525702</identifier><identifier>PMID: 36160656</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Apheresis ; Biopsy ; Care and treatment ; Case reports ; Causes of ; Complications and side effects ; cyclosporine ; Cytokines ; Diagnosis ; Dosage and administration ; Drug dosages ; eosinophilic granulomatosis with polyangiitis ; Ethics ; Funding ; Immunoglobulins ; Immunology ; Inflammatory diseases ; Laboratories ; Methylprednisolone ; methylprednisolone plus therapy ; mononeuropathy multiplex ; Myasthenia gravis ; Nervous system ; Patients ; Prednisolone ; Single Case – General Neurology ; Single Case − General Neurology ; Steroids ; Tomography ; Vein & artery diseases ; Wegener's granulomatosis</subject><ispartof>Case Reports in Neurology, 2022-07, Vol.14 (2), p.314-319</ispartof><rights>2022 The Author(s). Published by S. Karger AG, Basel</rights><rights>COPYRIGHT 2022 S. Karger AG</rights><rights>2022 The Author(s). Published by S. Karger AG, Basel . This work is licensed under the Creative Commons Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9386410/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9386410/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2101,27634,27923,27924,53790,53792</link.rule.ids></links><search><creatorcontrib>Uchi, Takahumi</creatorcontrib><creatorcontrib>Konno, Shingo</creatorcontrib><creatorcontrib>Kihara, Hideo</creatorcontrib><creatorcontrib>Matsushima, Mari</creatorcontrib><creatorcontrib>Sugimoto, Hideki</creatorcontrib><creatorcontrib>Oharaseki, Toshiaki</creatorcontrib><creatorcontrib>Takahashi, Kei</creatorcontrib><creatorcontrib>Fujioka, Toshiki</creatorcontrib><title>Myasthenia Gravis Complicated by Eosinophilic Granulomatosis with Polyangiitis: A Case Report</title><title>Case Reports in Neurology</title><addtitle>Case Rep Neurol</addtitle><description>A 55-year-old woman with a history of allergic sinusitis was being administered cyclosporine for ptosis and diplopia due to myasthenia gravis since age 46 years. She developed painful dysesthesia that began in her feet and later spread to her palms, leading to difficulty in walking. Eosinophils were markedly increased in the peripheral blood. Nerve conduction studies revealed mononeuritis multiplex. Nerve biopsy showed the infiltration of eosinophils in the superior neurovasculature. Based on these findings, eosinophilic granulomatous polyangiitis was diagnosed. Methylprednisolone pulse therapy was followed by oral prednisolone. Two weeks after treatment, the patient could do normal daily activities without assistance. In patients with myasthenia gravis having a history of allergic diseases, considering EGPA as a complication and monitoring prior changes in blood data are necessary for early detection before apparent tissue damage.</description><subject>Apheresis</subject><subject>Biopsy</subject><subject>Care and treatment</subject><subject>Case reports</subject><subject>Causes of</subject><subject>Complications and side effects</subject><subject>cyclosporine</subject><subject>Cytokines</subject><subject>Diagnosis</subject><subject>Dosage and administration</subject><subject>Drug dosages</subject><subject>eosinophilic granulomatosis with polyangiitis</subject><subject>Ethics</subject><subject>Funding</subject><subject>Immunoglobulins</subject><subject>Immunology</subject><subject>Inflammatory diseases</subject><subject>Laboratories</subject><subject>Methylprednisolone</subject><subject>methylprednisolone plus therapy</subject><subject>mononeuropathy multiplex</subject><subject>Myasthenia gravis</subject><subject>Nervous system</subject><subject>Patients</subject><subject>Prednisolone</subject><subject>Single Case – General Neurology</subject><subject>Single Case − General Neurology</subject><subject>Steroids</subject><subject>Tomography</subject><subject>Vein & artery diseases</subject><subject>Wegener's granulomatosis</subject><issn>1662-680X</issn><issn>1662-680X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DOA</sourceid><recordid>eNptks1r3DAQxU1padK0h957MOTUw6aSLMlWD4XFpEkg_SC00EsRY314tfVajqRN2f8-2jgsDRQdJL335scMTFG8xegMYyY-IIQYYTUiz4pjzDlZ8Ab9ev7P-6h4FeMaIS4Ypy-Lo4pjjjjjx8XvLzuIaWVGB-VFgDsXy9ZvpsEpSEaX3a4899GNflq5rO0j43bwG0hZjeVfl1bldz_sYOydSy5-LJdlC9GUN2byIb0uXlgYonnzeJ8UPz-f_2gvF9ffLq7a5fVC0UakBa-IUtBhgWjDuTaso5QS1hGNQOi9rJUG1VVgOdOGM1vnX4NrIWpFsn5SXM1c7WEtp-A2EHbSg5MPgg-9hJCcGoykmtOa0o4TZKnhFlRlheGNhg5VDOvM-jSzpm23MVqZMQUYnkCfOqNbyd7fSVE1nGKUAaePgOBvtyYmufbbMOb5JWkeJqTVPnU2p3rIXbnR-gxT-WizccqPxrqsL2tCBaoaWueC93OBCj7GYOyhJYzkfg3kYQ1y9t2c_QOhN-GQPNin_7Xbm69zQk7aVvdgBrmM</recordid><startdate>20220711</startdate><enddate>20220711</enddate><creator>Uchi, Takahumi</creator><creator>Konno, Shingo</creator><creator>Kihara, Hideo</creator><creator>Matsushima, Mari</creator><creator>Sugimoto, Hideki</creator><creator>Oharaseki, Toshiaki</creator><creator>Takahashi, Kei</creator><creator>Fujioka, Toshiki</creator><general>S. Karger AG</general><general>Karger Publishers</general><scope>M--</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20220711</creationdate><title>Myasthenia Gravis Complicated by Eosinophilic Granulomatosis with Polyangiitis: A Case Report</title><author>Uchi, Takahumi ; Konno, Shingo ; Kihara, Hideo ; Matsushima, Mari ; Sugimoto, Hideki ; Oharaseki, Toshiaki ; Takahashi, Kei ; Fujioka, Toshiki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-632ccab1904866de5b44425b2d0a9d1904dcdacb3af65de65f7acb817997c2cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Apheresis</topic><topic>Biopsy</topic><topic>Care and treatment</topic><topic>Case reports</topic><topic>Causes of</topic><topic>Complications and side effects</topic><topic>cyclosporine</topic><topic>Cytokines</topic><topic>Diagnosis</topic><topic>Dosage and administration</topic><topic>Drug dosages</topic><topic>eosinophilic granulomatosis with polyangiitis</topic><topic>Ethics</topic><topic>Funding</topic><topic>Immunoglobulins</topic><topic>Immunology</topic><topic>Inflammatory diseases</topic><topic>Laboratories</topic><topic>Methylprednisolone</topic><topic>methylprednisolone plus therapy</topic><topic>mononeuropathy multiplex</topic><topic>Myasthenia gravis</topic><topic>Nervous system</topic><topic>Patients</topic><topic>Prednisolone</topic><topic>Single Case – General Neurology</topic><topic>Single Case − General Neurology</topic><topic>Steroids</topic><topic>Tomography</topic><topic>Vein & artery diseases</topic><topic>Wegener's granulomatosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uchi, Takahumi</creatorcontrib><creatorcontrib>Konno, Shingo</creatorcontrib><creatorcontrib>Kihara, Hideo</creatorcontrib><creatorcontrib>Matsushima, Mari</creatorcontrib><creatorcontrib>Sugimoto, Hideki</creatorcontrib><creatorcontrib>Oharaseki, Toshiaki</creatorcontrib><creatorcontrib>Takahashi, Kei</creatorcontrib><creatorcontrib>Fujioka, Toshiki</creatorcontrib><collection>Karger Open Access</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Case Reports in Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uchi, Takahumi</au><au>Konno, Shingo</au><au>Kihara, Hideo</au><au>Matsushima, Mari</au><au>Sugimoto, Hideki</au><au>Oharaseki, Toshiaki</au><au>Takahashi, Kei</au><au>Fujioka, Toshiki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myasthenia Gravis Complicated by Eosinophilic Granulomatosis with Polyangiitis: A Case Report</atitle><jtitle>Case Reports in Neurology</jtitle><addtitle>Case Rep Neurol</addtitle><date>2022-07-11</date><risdate>2022</risdate><volume>14</volume><issue>2</issue><spage>314</spage><epage>319</epage><pages>314-319</pages><issn>1662-680X</issn><eissn>1662-680X</eissn><abstract>A 55-year-old woman with a history of allergic sinusitis was being administered cyclosporine for ptosis and diplopia due to myasthenia gravis since age 46 years. She developed painful dysesthesia that began in her feet and later spread to her palms, leading to difficulty in walking. Eosinophils were markedly increased in the peripheral blood. Nerve conduction studies revealed mononeuritis multiplex. Nerve biopsy showed the infiltration of eosinophils in the superior neurovasculature. Based on these findings, eosinophilic granulomatous polyangiitis was diagnosed. Methylprednisolone pulse therapy was followed by oral prednisolone. Two weeks after treatment, the patient could do normal daily activities without assistance. In patients with myasthenia gravis having a history of allergic diseases, considering EGPA as a complication and monitoring prior changes in blood data are necessary for early detection before apparent tissue damage.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>36160656</pmid><doi>10.1159/000525702</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Case Reports in Neurology, 2022-07, Vol.14 (2), p.314-319 |
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| subjects | Apheresis Biopsy Care and treatment Case reports Causes of Complications and side effects cyclosporine Cytokines Diagnosis Dosage and administration Drug dosages eosinophilic granulomatosis with polyangiitis Ethics Funding Immunoglobulins Immunology Inflammatory diseases Laboratories Methylprednisolone methylprednisolone plus therapy mononeuropathy multiplex Myasthenia gravis Nervous system Patients Prednisolone Single Case – General Neurology Single Case − General Neurology Steroids Tomography Vein & artery diseases Wegener's granulomatosis |
| title | Myasthenia Gravis Complicated by Eosinophilic Granulomatosis with Polyangiitis: A Case Report |
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