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Acute bilateral brachial plexus neuritis associated with hypersensitivity vasculitis

A case report and review of literature


The occurence 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 aggresive 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.

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  1. 1.

    Tsairis P, Dyck PJ, Mulder DW (1972) Natural history of brachial plexus neuropathy. Arch Neurol 27:109–117

    Google Scholar 

  2. 2.

    Churg J, Strauss L (1951) Allergic granulomatosis, allergic angiitis and periarteritis nodosa. Am J Pathol 27:277–294

    Google Scholar 

  3. 3.

    Sheeman B, Harrisman DGF, Bradshaw JPP (1958) Polyarteritis nodosa with ophthalmic and neurologic complications. Arch Ophthalmol 60:537–547

    Google Scholar 

  4. 4.

    Churg J (1963) Allergic granulomatosis and granulomatous vascular syndromes. Ann Allergy 21:619–628

    Google Scholar 

  5. 5.

    Ford RG, Siekert RG (1965) Central nervous system and manifestation of periarteritis nodosa. Neurology 15:114–122

    Google Scholar 

  6. 6.

    Chumblee LC, Harrison EG, DeRemee RA (1977) Allergic granulomatosis and angiitis (Churg-Strauss Syndrome). Report and analysis of 30 cases. Mayo Clin Proc 52:477–484

    Google Scholar 

  7. 7.

    Cohen RD, Conn DL, Ilstrup DM (1980) Clinical features, prognosis and response to treatment in polyarteritis. Mayo Clin Proc 55:146–155

    Google Scholar 

  8. 8.

    Moore PM, Fauci AS (1981) Neurologic manifestation of systemic vasculitis. Am J Med 71:517–524

    Google Scholar 

  9. 9.

    Kernoham JW, Woltman HW (1938) Periarteritis Nodosa. A clinopathologic study with special reference to the nervous system. Arch Neurol Psych 39:655–686

    Google Scholar 

  10. 10.

    Allan SG, Towla HMA, Smith CC, Downie AW, Clark JC (1982) Painful brachial plexopathy: an unusual presentation of polyarteritis nodosa. Postgr Med J 58:311–313

    Google Scholar 

  11. 11.

    Kolb LC, Grey SJ (1946) Peripheral neuritis as a complication of penicillin therapy. JAMA 132:323–326

    Google Scholar 

  12. 12.

    Turner JC, Jackson H Jr, Parker FJ (1938) The etiologic relation of the eosinophil to the Gordon phenomenon in Hodgkin's disease. Am J Med Sci 195:27–32

    Google Scholar 

  13. 13.

    McNaught JB (1938) The Gordon test for Hodgkin's disease. A reaction to eosinophils. JAMA 111:1280–1284

    Google Scholar 

  14. 14.

    Durack DT, Suni SM, Klebanoff SJ (1979) Neurotoxicity of human eosinophils. Proc Nat Acad Sci 76:1443–1447

    Google Scholar 

  15. 15.

    Meyer JS, Foley JM (1953) The encephalopathy produced by extracts of eosinophils and bone marrow. J Neuropathol Exp Neurol 12:349–362

    Google Scholar 

  16. 16.

    Chusid MJ, Dale DC, West BC, Wolf SM (1975) The hypereosinophilic syndrome. Medicine 54:1–27

    Google Scholar 

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Raz, I., Leitersdorf, E. & Kleinman, Y. Acute bilateral brachial plexus neuritis associated with hypersensitivity vasculitis. Klin Wochenschr 63, 643–645 (1985).

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Key words

  • Brachial plexopathy
  • Churg-Strauss syndrome
  • Sacral plexopathy
  • Eosinophilia