A case of CNS-limited ANCA-associated vasculitis presenting as recurrent ischemic stroke

Kayo Wakisaka, Noriko Hagiwara, Yuka Kanazawa, Shuji Arakawa, Tetsuro Ago, Takanari Kitazono

Research output: Contribution to journalArticle

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Abstract

A 73-year-old man was admitted to our hospital because of a decrease in spontaneity. His medical history included two stroke episodes, probably related to hypertension. Brain MRI on admission demonstrated acute infarction in the right caudate nucleus and left putamen. Intravenous infusion of a low molecular-weight heparin added to oral antiplatelets was started. Following admission, he developed a low grade fever and severe inflammatory reaction. The focus of infection was not evident, and none of the antibiotics tried were effective. Ten days after admission, he developed right hemiparesis, and an additional brain MRI showed new multiple infarctions. We also determined the presence of a high MPO-ANCA titer (57 EU), and we diagnosed the patient's condition to be ANCA-associated vasculitis (AAV). Steroid therapy improved his inflammatory reaction and stroke recurrence was not observed. We suggest that vasculitis should be considered as a potential risk factor for repeated small infarctions with fever of unknown origin, especially those of perforating artery territories.

Original languageEnglish
Pages (from-to)429-433
Number of pages5
JournalClinical Neurology
Volume54
Issue number5
DOIs
Publication statusPublished - Jan 1 2014

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Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Infarction
Stroke
Fever of Unknown Origin
Antineutrophil Cytoplasmic Antibodies
Caudate Nucleus
Putamen
Low Molecular Weight Heparin
Brain
Paresis
Vasculitis
Intravenous Infusions
Fever
Arteries
Steroids
Anti-Bacterial Agents
Hypertension
Recurrence
Infection
Therapeutics

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

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A case of CNS-limited ANCA-associated vasculitis presenting as recurrent ischemic stroke. / Wakisaka, Kayo; Hagiwara, Noriko; Kanazawa, Yuka; Arakawa, Shuji; Ago, Tetsuro; Kitazono, Takanari.

In: Clinical Neurology, Vol. 54, No. 5, 01.01.2014, p. 429-433.

Research output: Contribution to journalArticle

Wakisaka, Kayo ; Hagiwara, Noriko ; Kanazawa, Yuka ; Arakawa, Shuji ; Ago, Tetsuro ; Kitazono, Takanari. / A case of CNS-limited ANCA-associated vasculitis presenting as recurrent ischemic stroke. In: Clinical Neurology. 2014 ; Vol. 54, No. 5. pp. 429-433.
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