Eosinophilic granulomatosis with polyangiitis and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in a 52-year-old woman: A case report

9^th International Conference on Clinical & Medical Case Reports

September 27-28, 2018 | Amsterdam, Netherlands

Samira Hossaini Alhashemi

Shiraz University of Medical Sciences, Iran

Scientific Tracks Abstracts: J Clin Case Rep

Abstract :

Eosinophilic granulomatosis with polyangiitis formerly named �??Churg-Strauss syndrome (CSS)�?� is a systemic disease with bronchial asthma, hypereosinophilia, and systemic vasculitis. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an autosomal dominantly inherited angiopathy caused by mutations in the NOTCH3 gene. The major clinical manifestations of CADASIL are transient ischemic attack (TIA), ischemic stroke, migraine with aura, and neuropsychiatric disturbances. We report a rare case of CSS with CADASIL. A 52-year-old woman with a known history of hypertension, hyperlipidemia, heart failure, episodic migraine headaches, and cerebral vascular accident was referred to a university hospital with the chief complaint of drowsiness, nausea, and vomiting. The patient medication history was as follows: Atorvastatin 40 mg/day, Captopril 25 mg twice daily, Clopidogrel 75 mg/ day, Carvedilol 12.5 mg/day, and Isosorbide dinitrate 10 mg/day. The laboratory findings included remarkable eosinophilia (11%), an elevated erythrocyte sedimentation rate (49 mm/hr), elevated blood urea nitrogen (74 mg/dl) as well as serum creatinine (7.8 mg/dl) and significant increase in perinuclear anti-neutrophil cytoplasmic antibodies (256 U/ml). Her parents and one sibling had a positive history of stroke. The chest CT showed cystic bronchiectasis with two nodules (6.5 and 5.5 mm) in the right lower lobe. Molecular genetic test revealed mutation in the NOTCH3 gene. She was diagnosed with CSS and CADASIL. The patient was treated with prednisolone (50 mg per day orally) and therapeutic apheresis (5 sessions).

Biography :

Samira Hossaini Alhashemi has completed her Pharm.D. from Shiraz University of Medical Sciences, Iran at 2013. She was senior inspector at food and drug organization since 2013- 2015. She was technical manager of a drug distribution company at 2016. She has awarded 2 travel grants from Basel Life Science Week to present her research activities in scientific conferences. Now, she is resident of clinical pharmacy at Shiraz University of Medical Sciences, Iran.

E-mail: shossaini@sums.ac.ir