ArticleBMC rheumatology2025
Unraveling cerebrovascular involvement in EGPA through digital subtraction angiography: case presentation and systematic literature review.
Article in BMC rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Chandipura virus encephalitis: an emerging pediatric neurotropic threat in india-virology, epidemiology, pathogenesis, and public health challenges.Journal of neurovirology · 2026Review
- Vasculitis syndromes: large vessel vasculitides and ANCA-associated vasculitides from a neuroradiologist's perspective.Japanese journal of radiology · 2026Review
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7 authors.
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Abstract
objectivesEosinophilic granulomatosis with polyangiitis (EGPA) involves systemic inflammation of small to medium vessels, with central nervous system (CNS) involvement being rare. While CT (computed tomography) and MRI (magnetic resonance imaging) are standard for diagnosing CNS involvement, digital subtraction angiography (DSA) is infrequently used. We present a unique EGPA case with CNS involvement and review EGPA CNS vascular variations.
methodsWe present a case of EGPA with CNS involvement, alongside a systematic review of the literature following PRISMA guidelines, querying three databases (PubMed/MEDLINE, SCOPUS, and Science Direct) up to September 2023 for case reports and series on EGPA with CNS involvement.
resultsA 43-year-old presented with wheezing, multifocal neuropathy, leukocytosis, eosinophilia, positive ANA, and elevated CRP. Imaging revealed lung abnormalities. CT and MRI showed cerebral infarcts. CTA was negative, whereas DSA revealed bilateral segmental narrowing of anterior cerebral artery (ACA) branches and middle cerebral artery (MCA) branches. EGPA was confirmed, and treatment with steroids, cyclophosphamide, and azathioprine, led to remission. A systematic literature review of 27 EGPA cases with CNS involvement found a mean age 54.22 years, with common symptoms including extremity weakness (n = 8) and paresthesia (n = 5). Imaging techniques included MRI (n = 21), CT (n = 11), angiogram (n = 8), MRA (n = 4), CTA (n = 4), and MRV (n = 2), revealing stenosis of the bilateral ACA, vertebral artery, MCA, and basilar artery.
conclusionOur findings suggest a potentially novel role for angiographic imaging in the comprehensive assessment of cerebrovascular involvement in EGPA.
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