Clinical features of allergic granulomatosis polyangiitis with neurologic involvement: an analysis of 5 cases / 中华全科医师杂志

ABSTRACT

Ten patients with allergic granulomatosis with polyangiitis (AGPA) were admitted in Nanjing Drum Tower Hospital during January 2013 to August 2019, among whom 5 cases with neurologic involvement. The clinical features, laboratory findings and clinical outcome of the 5 patients were analyzed and literature review was performed. Among 5 cases of AGPA with neurologic involvement, 3 presented with peripheral neuropathy as the initial symptom, 2 had multiple mononeuropathy, 3 had distal asymmetric or symmetric polyneuropathy. All five patients had acute or subacute onset, and the symptoms of limb numbness or pain were prominent. Electrophysiological examination showed that sensory and motor conduction amplitude significantly decreased or disappeared. Eight of the 10 AGPA patients were treated with corticosteroid combined with immunosuppressants, 2 were treated with corticosteroid alone. Eight patients had good prognosis and 2 patients died. The results suggest that peripheral neuropathy is common in AGPA. When the patients present with acute or subacute onset of axonal impairment of peripheral neuropathy and elevated eosinophils, AGPA should be considered.