Eosinophilic granulomatosis with polyangiitis (EGPA) is an immune related systemic disease that is caused by vasculitis affecting multiple organ systems. It is characterized by asthma, fever, eosinophilia, cardiac problems, renal injury, and peripheral neuropathy. In this report, we describe a patient with EGPA with concurrent cerebral infarction and acute polyneuropathy mimicking a Guillain-Barre syndrome (GBS). A 46-year-old man presented with rapidly progressing gait disturbance, muscular weakness, and tingling sensation in all four limbs. A nerve conduction study revealed sensorimotor polyneuropathy in all four limbs, and a test of the cerebrospinal fluid showed an albumin-cytologic dissociation. In addition, brain magnetic resonance imaging (MRI) using fluid-attenuated inversion recovery and diffusion weighted MRI revealed high signal intensity lesions with gadolinium enhancement on T1-weighted MRI in the right caudate nucleus. After performing laboratory tests, paranasal sinus computed tomography, and a nasal smear, the patient was diagnosed with EGPA and treated with high dose glucocorticoid and oral cyclophosphamide. In conclusion, our findings indicate that a diagnosis of EGPA should be considered when a patient presents with rapidly progressing polyneuropathy mimicking a GBS along with unusual systemic symptoms or brain lesions.

中文翻译：

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嗜酸性肉芽肿伴多血管炎表现为急性多发性神经病和脑血管炎。

嗜酸性肉芽肿性多血管炎（EGPA）是一种免疫相关的全身性疾病，由影响多个器官系统的血管炎引起。它的特征是哮喘，发烧，嗜酸性粒细胞增多，心脏问题，肾损伤和周围神经病变。在本报告中，我们描述了患有EGPA并发脑梗塞和模拟多发性格林-巴利综合征（GBS）的急性多发性神经病的患者。一名46岁的男子四肢快速步态紊乱，肌肉无力和刺痛感。一项神经传导研究显示所有四个肢体都有感觉运动性多发性神经病，而对脑脊液的测试显示白蛋白-细胞学解离。此外，脑磁共振成像（MRI）使用液体衰减反转恢复和弥散加权MRI揭示了右尾状核T1加权MRI上high增强的高信号强度病变。在进行实验室检查，鼻旁窦计算机断层扫描和鼻涂片检查后，患者被诊断出患有EGPA，并接受了大剂量糖皮质激素和口服环磷酰胺治疗。总之，我们的发现表明，当患者出现快速发展的多发性神经病，模仿GBS并伴有异常的全身症状或脑部病变时，应考虑诊断EGPA。患者被诊断出患有EGPA，并接受大剂量糖皮质激素和口服环磷酰胺治疗。总之，我们的发现表明，当患者出现快速发展的多发性神经病，模仿GBS并伴有异常的全身症状或脑部病变时，应考虑诊断EGPA。患者被诊断出患有EGPA，并接受大剂量糖皮质激素和口服环磷酰胺治疗。总之，我们的发现表明，当患者出现快速发展的多发性神经病，模仿GBS并伴有异常的全身症状或脑部病变时，应考虑诊断EGPA。