A case of CNS-limited ANCA-associated vasculitis presenting as recurrent ischemic stroke
| Autor: | Shuji Arakawa, Takanari Kitazono, Kayo Wakisaka, Yuka Kanazawa, Noriko Hagiwara, Tetsuro Ago |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Prednisolone Infarction Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Fever of Unknown Origin Methylprednisolone Antibodies Antineutrophil Cytoplasmic Low-grade fever Recurrence Risk Factors Internal medicine Humans Medicine Medical history cardiovascular diseases Fever of unknown origin Aged Peroxidase medicine.diagnostic_test Heparin business.industry Anticoagulants Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Stroke medicine.anatomical_structure Pulse Therapy Drug Warfarin Neurology (clinical) business Vasculitis Biomarkers medicine.drug Artery |
| Zdroj: | Rinsho Shinkeigaku. 54:429-433 |
| ISSN: | 1882-0654 0009-918X |
| Popis: | A 73-year-old man was admitted to our hospital because of a decrease in spontaneity. His medical history included two stroke episodes, probably related to hypertension. Brain MRI on admission demonstrated acute infarction in the right caudate nucleus and left putamen. Intravenous infusion of a low molecular-weight heparin added to oral antiplatelets was started. Following admission, he developed a low grade fever and severe inflammatory reaction. The focus of infection was not evident, and none of the antibiotics tried were effective. Ten days after admission, he developed right hemiparesis, and an additional brain MRI showed new multiple infarctions. We also determined the presence of a high MPO-ANCA titer (57 EU), and we diagnosed the patient's condition to be ANCA-associated vasculitis (AAV). Steroid therapy improved his inflammatory reaction and stroke recurrence was not observed. We suggest that vasculitis should be considered as a potential risk factor for repeated small infarctions with fever of unknown origin, especially those of perforating artery territories. |
| Databáze: | OpenAIRE |
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