Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitis
Abstract 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 cytopl...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Clinical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ccr3.6725 |
| _version_ | 1797951421033742336 |
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| author | John Chuan Nguyen Tran Joshua Haron Abasszade Yew Li Dang Douglas Ewan Crompton |
| author_facet | John Chuan Nguyen Tran Joshua Haron Abasszade Yew Li Dang Douglas Ewan Crompton |
| author_sort | John Chuan Nguyen Tran |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-10T22:31:25Z |
| format | Article |
| id | doaj.art-034928eacd824a76b46547f159be37db |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-04-10T22:31:25Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-034928eacd824a76b46547f159be37db2023-01-17T04:40:57ZengWileyClinical Case Reports2050-09042022-12-011012n/an/a10.1002/ccr3.6725Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitisJohn Chuan Nguyen Tran0Joshua Haron Abasszade1Yew Li Dang2Douglas Ewan Crompton3Northern Health Neurology Department Epping Victoria AustraliaNorthern Health Neurology Department Epping Victoria AustraliaNorthern Health Neurology Department Epping Victoria AustraliaNorthern Health Neurology Department Epping Victoria AustraliaAbstract 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.https://doi.org/10.1002/ccr3.6725ANCAmyeloperoxidase antineutrophilic cytoplasmic autoantibodyproteinase 3 autoantibodiesstrokevasculitis |
| spellingShingle | John Chuan Nguyen Tran Joshua Haron Abasszade Yew Li Dang Douglas Ewan Crompton Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitis Clinical Case Reports ANCA myeloperoxidase antineutrophilic cytoplasmic autoantibody proteinase 3 autoantibodies stroke vasculitis |
| title | Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitis |
| title_full | Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitis |
| title_fullStr | Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitis |
| title_full_unstemmed | Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitis |
| title_short | Ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody‐associated vasculitis |
| title_sort | ischaemic stroke as the first presentation of antineutrophilic cytoplasmic autoantibody associated vasculitis |
| topic | ANCA myeloperoxidase antineutrophilic cytoplasmic autoantibody proteinase 3 autoantibodies stroke vasculitis |
| url | https://doi.org/10.1002/ccr3.6725 |
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