A 47-year-old female who had a history of asthma and sinusitis in the past was admitted to hospital with limbs numbness and pain for ten days. The symptoms were aggravated for eight hours. On admission, significant peripheral eosinophilia was noted. Paranasal sinusitis and transient bronchiolitis were found by CT scan.Electromyogram demonstrated multiple mononeuropathy. Eosinophilia was indicated by bone marrow biopsy. The diagnosis of eosinophilic granulomatous polyangiitis(EGPA) was determined. The patient got better after applying glucocorticoid and cyclophosphamide.Later she developed abdominal pain and partial oculomotor nerve palsy, while her condition improved after continued immunosuppression and anticoagulant therapy. She was hospitalized for the third time because of headache. Subarachnoid hemorrhage was diagnosed after lumber puncture and cranial MRI+MRA+MRV and other examinations. She was relieved after conservative treatment. Subarachnoid hemorrhage with EGPA is rare. This case may improve physicians' understanding of EGPA complicated with subarachnoid hemorrhage.
患者女，47岁，因肢体麻木、疼痛10 d，加剧8 h入院。患者既往有“哮喘、鼻窦炎”史，入院查外周血嗜酸性粒细胞显著增加、CT平扫示副鼻窦炎及一过性细支气管炎，肌电图提示多发性单神经病，骨髓穿刺活检呈嗜酸性粒细胞增多症骨髓象，确诊为嗜酸性肉芽肿性多血管炎（EGPA），经激素、环磷酰胺等治疗好转。随后出现腹痛及部分性动眼神经麻痹，继续抑制免疫并抗凝治疗后好转。患者因头痛第3次住院，经腰椎穿刺术和头颅磁共振成像+磁共振血管成像+磁共振静脉成像等检查后诊断蛛网膜下腔出血，保守治疗后好转。EGPA并蛛网膜下腔出血罕见，本文旨在提高临床医师对该病的认识。.