Lateral Medullary Stroke in Patient with Granulomatous Polyangiitis

Taraschenko, Olga; Amory, Colum F.; Waldman, Jonathan; Hanspal, Era; Bernardini, G.

doi:10.1016/j.jstrokecerebrovasdis.2013.09.004

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…Cerebrovascular disease in antineutrophil cytoplasmic autoantibody- (ANCA-) associated vasculitis is exceedingly rare and tends to have a poor prognosis [ 6 – 9 ]. Most case reports describe a rapidly progressive clinical course with high mortality due to a subsequent hemorrhage or hemorrhagic conversion [ 8 , 10 , 11 ]. Additionally, in these few patients, ischemic strokes are usually present in the acute phase of the untreated vasculitis and may even be part of the initial presentation.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, in these few patients, ischemic strokes are usually present in the acute phase of the untreated vasculitis and may even be part of the initial presentation. Furthermore, different affected areas of stroke have been described including the bilateral corona radiata, the left pons, the lateral medullary, and the right medulla oblongata [ 7 , 8 , 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most common etiology of ischemic strokes in patients with granulomatosis with polyangiitis (GPA) is the inflammation of medium-sized intracranial arteries with associated thrombosis, but other mechanisms have been described including cardioembolic events, arterial dissection, and direct invasion from the nasal cavity, which could explain the wide variety of CNS territories affected [ 11 ]. Moreover, a study in 2017 has described accelerated atherosclerosis in patients with ANCA-associated vasculitis reporting the presence of carotid atherosclerotic plaques in 30.4% of patients [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Amnesia in a Patient with Rheumatoid Arthritis: A Case of Granulomatosis with Polyangiitis

Weilg

Diaz-Zamora

Young

2020

Case Reports in Rheumatology

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A 56-year-old male with a history of seropositive rheumatoid arthritis complained of polyarthritis and forgetfulness. The initial CT scan of the head without contrast was negative for acute pathologies. However, as he continued to decline despite being on oral prednisone, an MRI of the head was ordered and revealed a subtle small region of acute infarction in the left mammillary body. He was diagnosed with granulomatosis with polyangiitis in light of his positive C-ANCA antibodies, PR3 antibody, and a kidney biopsy, which showed focal necrotizing pauci-immune crescentic glomerulonephritis. Despite undergoing steroid pulse therapy, the patient developed diffuse alveolar damage which finally responded to rituximab infusion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Amnesia in a Patient with Rheumatoid Arthritis: A Case of Granulomatosis with Polyangiitis

Weilg

Diaz-Zamora

Young

2020

Case Reports in Rheumatology

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“…Ischemic stroke is a rare event and usually presents in the acute phase of untreated GPA [7]. The most important mechanisms are vasculitis of the medium-sized intracranial arteries with associated thrombosis, cardiac embolism, arterial dissection, and direct invasion from the nasal cavity [8]. …”

Section: Discussionmentioning

confidence: 99%

“…The second one was by Taraschenko et al [8], who reported a 41-year-old man with lateral medullary infarction who rapidly developed progressive renal failure after that. He was diagnosed with GPA based on positive serum c-ANCA and pauci-immune crescentic glomerulonephritis on kidney biopsy.…”

Section: Discussionmentioning

confidence: 99%

Three atypical manifestations of granulomatosis with polyangiitis: lateral medullary syndrome, anterior cheek mass and melting scleritis of eye

Shenavandeh¹,

Petramfar²

2017

Reumatologia

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Granulomatosis with polyangiitis (GPA, formerly Wegener granulomatosis) is a vasculitis with various organ involvement. There have been a few cases of CNS stroke and rare cases of lateral medullary infarction (LMI) as a manifestation of GPA. Also there have been reports of sinuses, nose and laryngeal masses mistakenly referred as carcinomas and subsequently GPA was diagnosed in their pathological reports. Another severe fulminant manifestation can be necrotizing scleritis leading to perforation of sclera. Therefore, here we present some rare and fulminant manifestations of GPA in 3 separate cases for further emphasis of the unusual manifestations of GPA that should always be kept in mind.

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Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitis

Tran

Abasszade

Dang

et al. 2022

Clinical Case Reports

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The diagnosis of antineutrophil cytoplasmic autoantibody‐associated vasculitis in first‐episode strokes is particularly challenging, especially in patients lacking features of systemic vasculitis. We present the case of a 71‐year‐old woman with positive myeloperoxidase antineutrophil cytoplasmic antibodies and negative proteinase 3 autoantibodies. The patient presented with 1 week history of pyramidal weakness in both upper and lower limbs, hyperreflexia, and clonus. Magnetic resonance imaging of the brain demonstrated widespread bihemispheric cortical and deep white matter acute infarcts, which are consistent with features of stroke secondary to vasculitis. Myeloperoxidase antineutrophilic cytoplasmic autoantibody‐positive vasculitis diseases are more commonly associated with renal, pulmonary, and cutaneous manifestations; however, in our patient, the central nervous system features predominated. This case highlights the challenges of diagnosing primary central nervous system vasculitis, in this case, an atypical myeloperoxidase antineutrophilic cytoplasmic autoantibody‐positive disease without the classical disease course and clinical signs.

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Lateral Medullary Stroke in Patient with Granulomatous Polyangiitis

Cited by 7 publications

References 11 publications

Amnesia in a Patient with Rheumatoid Arthritis: A Case of Granulomatosis with Polyangiitis

Amnesia in a Patient with Rheumatoid Arthritis: A Case of Granulomatosis with Polyangiitis

Three atypical manifestations of granulomatosis with polyangiitis: lateral medullary syndrome, anterior cheek mass and melting scleritis of eye

Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitis

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