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Mild deficit of proximal strength in the lower limbs. Not sensory levels. He was able to walk on points and heels. Laboratory examination revealed white blood count 28.5 × 10 9 (eosinophils 61%); C-reactive protein level was 62 mg/dL (normally 0.0-5.0 mg/dL); creatine kinase and transaminase levels was increased, respectively 62 mg/dL and 93 mg/dL. Chest x-ray and head computed tomography scan were normal. The patient was admitted in the neurological ward. Blood exams confirmed leukocytosis with hypereosinophilia. Serum tests were positive for ANCA. Nerve conduction studies showed a neurogenic suffering of the investigated muscles, compatible with axonal motor nerve distress with blocks of motor conduction and sensory axonal suffering with asymmetric distribution; these findings were suggestive of multiplex mononeuritis. Nerve biopsy showed features of axonopathy. Muscle biopsy showed a picture with features of eosinophilic vasculitis. Spirometry was normal, with a FEV1/FVC rate of 77% of predicted. He was treated with intravenous methyl-prednisolone and Cyclophosphamide, followed by maintenance with azathioprine. After some days of therapy a blood exam control showed: White blood count 20.5 × 10 9 (eosinophils 5%); C-reactive protein level 5 mg/dL; creatine kinase levels 51 mg/dL, and transaminase levels 30 mg/dL. Patient improved and there was no recurrence of symptoms since about two years of follow-up.

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Introduction: Ischemic stroke is account for most of the mortality and morbidity cases around the World. Paraoxonase-1 (PON1) is a significant candidate gene for ischemic stroke because of its function against atherosclerosis. Methods: We studied two common polymorphisms (Q192R [rs662] and L55M [rs854560]) of PON1 gene using PCR-based RFLP assay. Overall, 107 patients diagnosed as acute ischemic stroke and 99 healthy controls were enrolled in the present study. We also carried out a meta-analysis containing 3 case-control studies from Turkey. Results: Allele frequencies of PON1 gene Q192R and L55M polymorphisms didn't demonstrate any significant differences between patients and controls (p > 0.05). However, genotype frequencies were significantly different between patients and controls in terms of Q192R polymorphism (p = 0.030). Statistically significant correlations were observed between systolic and diastolic blood pressures of patients and L55M polymorphism (p = 0.017 and p = 0.039, respectively). Heterozygosity for the both Q192R and L55M polymorphisms demonstrated a statistically significant association with acute ischemic stroke in composite genotype analyses (p = 0.033). The results of meta-analysis showed a significant correlation between acute ischemic stroke and the PON1 gene L55M polymorphism in Turkish population. Conclusion: PON1 gene Q192R and L55M polymorphisms may have effects on acute ischemic stroke susceptibility in Turkish population.