A case of Takayasu arteritis complicated by eosinophilic granulomatosis with polyangiitis, followed by common carotid artery occlusion

Abstract

Objective: We present a rare case of Takayasu arteritis complicated by eosinophilic granulomatosis with polyangiitis (EGPA), followed by common carotid artery occlusion. Case Presentation: A 49-year-old woman with a history of EGPA rapidly developed left hemiplegia. MRI revealed acute infarction in the right middle cerebral artery territory. The right common carotid artery was not visualized on magnetic resonance angiography. She was transferred to our hospital for a detailed examination. Her erythrocyte sedimentation rate and C-reactive protein level were slightly increased. PET-CT showed high uptake in the aortic arch, right innominate artery, and common carotid artery, which supported the diagnosis of Takayasu arteritis. Rest 123 I-IMP-SPECT demonstrated low uptake in the right middle cerebral artery territory; therefore, subclavian-carotid bypass for revascularization of the right carotid artery was performed. She eventually recovered well from the surgery and was discharged home. Conclusion: Revascularization for common carotid artery occlusion of Takayasu arteritis with EGPA was safe and effective in improving the neurological status, and it should be performed while the disease is inactive.