Intravenous Methylprednisolone for Acute Right Middle Cerebral Artery Occlusion in Granulomatosis Polyangiitis: A Case Report

Tsubasa Watanabe; Nakako Tanaka-Mabuchi; Yuto Morishima; Takanori Hata; Ryosuke Ito; Sho Nakajima; Atsuhiko Shindo; Yuki Nakamura; Hideyuki Yoshioka; Koji Hashimoto; Kazumasa Shindo; Hiroyuki Kinouchi; Daiki Nakagomi; Yuji Ueno

doi:10.2169/internalmedicine.4873-24

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Intravenous Methylprednisolone for Acute Right Middle Cerebral Artery Occlusion in Granulomatosis Polyangiitis: A Case Report

Tsubasa Watanabe, Nakako Tanaka-Mabuchi, Yuto Morishima, Takanori Hata, Ryosuke Ito, Sho Nakajima, Atsuhiko Shindo, Yuki Nakamura, Hideyuki Yoshioka, Koji Hashimoto, Kazumasa Shindo, Hiroyuki Kinouchi, Daiki Nakagomi, Yuji Ueno

著者情報

キーワード: granulomatosis polyangiitis, cerebral infarction, vasculitis, middle cerebral artery occlusion

ジャーナルオープンアクセス早期公開

論文ID: 4873-24

DOI https://doi.org/10.2169/internalmedicine.4873-24

この記事には本公開記事があります。

The final version of this article is now available: Vol. 64 (2025), No. 20 pp. 3027-3032

詳細

抄録

A 17-year-old Japanese woman diagnosed with granulomatosis with polyangiitis (GPA) and was treated with immunotherapy suddenly developed an impaired consciousness, left hemiplegia, and conjugate eye deviation to the right. Magnetic resonance imaging showed an acute cerebral infarction in the right striatum and right middle cerebral artery (MCA) occlusion. As her GPA had worsened recently, intravenous methylprednisolone (IVMP) was started. Immediately after IVMP was started, recanalization of the MCA was detected on repeat cerebral angiography. Aspirin and argatroban dissolved the residual thrombi. A combination of IVMP and antithrombotic therapy may be effective for large-vessel occlusions associated with GPA.

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