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Case Reports in Neurological Medicine
Volume 2015, Article ID 981439, 3 pages
http://dx.doi.org/10.1155/2015/981439
Case Report

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

1Servicio de Neurologia, Hospital Universitario “Dr. José E. González” y Facultad de Medicina, Universidad Autónoma de Nuevo León, Madero y Gonzalitos, S/N, 64460 Monterrey, NL, Mexico
2Departamento de Medicina Interna, Hospital Universitario “Dr. José E. González” y Facultad de Medicina, Universidad Autónoma de Nuevo León, Madero y Gonzalitos, S/N, 64460 Monterrey, NL, Mexico

Received 26 May 2015; Revised 13 June 2015; Accepted 15 June 2015

Academic Editor: Peter Berlit

Copyright © 2015 Carlos R. Camara-Lemarroy et al. 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.

Abstract

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.