Acute polyneuropathy resembling Guillain Barre Syndrome in Eosinophilic Granulomatosis with Polyangiitis

Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) is an anti neutrophil cytoplasmic antibody related small vessel vasculitis which occurs exclusively in patients with asthma and eosinophilia. Vessel inflammation and eosinophilic infiltration leads to organ damage with high incidence of neurological involvement. We report a 58 year old patient who presented with rapidly ascending weakness with hyporeflexia mimicking Guillain Barre syndrome (GBS) clinically. A history of bronchial asthma, peripheral eosinophilia and eosinophilic infiltrates in sural nerve biopsy confirmed it to be a case of EGPA. He was treated with methylprednisolone and cyclophosphamide and had good response after completion of treatment. This case highlights the rare presentation of EGPA as GBS like polyneuropathy.