LAUSR

Eosinophilic granulomatosis with poliangiitis (EGPA; formerly known as Churg Strauss syndrome) is a systemic disorder characterised by asthma, peripheral eosinophilia, sinusitis and affection of different organic systems, e.g. peripheral nervous system, skin, kidney and gastrointestinal tract. EGPA is a rare entity that is characterised by widespread vasculitis which affects both small and medium sized blood vessels, but in most cases initial clinical manifestations are asthma and skin changes (Sinico & Bottero 2009). The pathogenetic mechanisms are not completely clear. Following criteria are widely used for the EGPA diagnosis: asthma, eosinophilia (more than 10% in complete blood count CBC), monoor polyneuropathy, pulmonary infiltrates (may be transient), paranasal sinusitis and extra-vascular eosinophils (biopsy of arteries, arterioles or venules may demonstrate presence of eosinophilic infiltrates in the extravascular area) (Groh et al. 2015). EGPA is a rare systemic disorder. The annual incidence varies according to the published literature, with estimated prevalence of 17.8/ 1.000.000 (Watts et al. 2005). The most common neurologic manifestation of EGPA are peripheral neuropathy, usually mononeuritis simplex which untreated, may progress to symmetric or asymmetric polyneuropathy. Central nervous system (CNS) involvement (cerebral infarction and haemorrhage) is rare (Wolf et al. 2010). Eosinophilic vasculitis affects central nervous system (CNS) in less than 10% of cases (Sinico & Bottero 2009). We present a case of a male patient with EGPA and depression that initially manifested with atypical and rare clinical presentation of recurrent transitory ischemic attacks (TIAs) with subsequent development of the ischemic stroke.