A presentation of recurrent cerebral ischemic stroke in eosinophilic granulomatosis with polyangiitis: a case report.

BACKGROUND: Eosinophilic granulomatosis with polyangiitis is characterized as a small vessel vasculitis with the propensity to have a myriad of presentations due to the targeting of several different organ systems. More often than not, it is the pulmonary system that is affected. However, other reported presentations have included involvement of the skin, cardiovascular system, neurological system, renal, musculoskeletal, and even gastrointestinal tract in sequential order of increasing rarity. In most of these reported cases, only one or a couple of systems are involved. Here, the authors present a case of eosinophilic granulomatosis with polyangiitis that has peculiar and ominous involvement of both the neurological and gastrointestinal systems, lending to its extreme rarity as well as severity. CASE PRESENTATION: A 69-year-old Eastern European female patient was diagnosed with eosinophilic granulomatosis with polyangiitis exhibiting extensive multisystem involvement. Her case included a rare documented instance of hemorrhagic shock secondary to ileal gastrointestinal bleeding, occurring concurrently with multiple cerebral vascular infarctions. CONCLUSION: This case highlights the complexity and severity of eosinophilic granulomatosis with polyangiitis when it involves multiple organ systems simultaneously. It emphasizes the importance of recognizing eosinophilic granulomatosis with polyangiitis as a differential diagnosis in patients presenting with multisystem disease and unexplained eosinophilia. The report also underscores the need for aggressive management strategies and vigilance in diagnosing rare manifestations such as gastrointestinal hemorrhage and recurrent cerebral ischemic strokes.