Acute bilateral brachial plexus neuritis associated with hypersensitivity vasculitis. A case report and review of literature.
The occurrence of brachial plexus neuritis during the acute phase of vasculitis is uncommon. We describe a patient with a long history of rhinitis and a recent onset of asthma, who developed purpuric skin lesions, abdominal pain, eosinophilia and brachial neuritis along with evidence of sacral plexus neuropathy. High dose steroids and cyclophosphamide induced a remission. He stopped all medications after 3 years and after 6 years the patient has some fixed minimal residual neurological deficit. The importance of aggressive therapy in treating extensive polyneuropathy during the acute phase of hypersensitivity vasculitis is raised. A possible cytotoxic role of eosinophils in the pathological process is suggested.
D000208:Acute Disease; D001249:Asthma / Q000150:complications; D001917:Brachial Plexus; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000150:complications; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D009443:Neuritis / Q000150:complications* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D012220:Rhinitis / Q000150:complications; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000150:complications* / Q000188:drug therapy
D003520:Cyclophosphamide; D011239:Prednisolone; D006854:Hydrocortisone