Intracerebral Hemorrhage with Churg Strauss-Syndrome: Multidisciplinary Collaboration and Literature Review

Vasc Health Risk Manag. 2024 Dec 14:20:567-578. doi: 10.2147/VHRM.S489212. eCollection 2024.

Abstract

Objective: To explore the clinical characteristics and treatment outcomes of intracerebral hemorrhage in eosinophilic granulomatosis with polyangiitis (EGPA).

Methods and patient presentation: We report an 18-year-old student of EGPA complicated with intracerebral hemorrhage. The laboratory tests showed a continuous increase in eosinophils. The CT of head and chest showed cerebral hemorrhage and pulmonary infiltration.

Interventions: The patient received an intravenous infusion of methylprednisolone 1g/(kg·d) and cyclophosphamide for 3 days, followed by oral prednisone 1 mg/(kg·d).

Outcomes: At discharge, the patient's head and chest CT showed obvious absorption of intracranial hematoma and improvement of pulmonary infiltration. We reviewed 40 previously published cases of EGPA with intracerebral hemorrhage focusing on the clinical features and treatment of intracerebral hemorrhage caused by EGPA.

Conclusion: For the cases of EGPA complicated with intracerebral hemorrhage, we should timely differentiate diagnosis and recognition. Early diagnosis with aggressive immunosuppressive therapy can help improve the prognosis of patients EGPA with intracerebral hemorrhage. When a patient is affected by EGPA, it is essential to remain vigilant for signs of Central Nervous System involvement. The treatment with glucocorticoids and cyclophosphamide is effective in managing EGPA.

Keywords: Churg Strauss-Syndrome; eosinophilia; eosinophilic granulomatosis with polyangiitis; intracerebral hemorrhage.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Cerebral Hemorrhage* / diagnostic imaging
  • Cerebral Hemorrhage* / etiology
  • Churg-Strauss Syndrome* / complications
  • Churg-Strauss Syndrome* / diagnosis
  • Churg-Strauss Syndrome* / drug therapy
  • Cyclophosphamide* / administration & dosage
  • Cyclophosphamide* / therapeutic use
  • Drug Therapy, Combination
  • Glucocorticoids* / administration & dosage
  • Glucocorticoids* / therapeutic use
  • Humans
  • Immunosuppressive Agents* / therapeutic use
  • Infusions, Intravenous
  • Male
  • Methylprednisolone / administration & dosage
  • Patient Care Team
  • Prednisone / therapeutic use
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Glucocorticoids
  • Cyclophosphamide
  • Methylprednisolone
  • Prednisone

Grants and funding

This work was supported by the Inner Mongolia Medical University Science and Technology Million Project [No. YKD2020KJDW(LH)063] and Inner Mongolia Health Commission Medical Health Technology Project [202201593].