Recurrent anemia to status epilepticus: A complex case of granulomatosis with polyangiitis with concurrent posterior reversible encephalopathy syndrome and intracranial hemorrhage
Full Text (PDF)
Wan Muhammad Nazrin Wan Nazman 1 , Mohd Noor Norhayati 1 * , Azlina Ishak 1 , Wan Syamimee Wan Ghazali 2 , Hafsah Sazali 2 , Nur Asyilla Che Jalil 3
More Detail
1 Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MALAYSIA2 Department of Internal Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MALAYSIA3 Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MALAYSIA* Corresponding Author

Abstract

Granulomatosis with polyangiitis (GPA) is a type of antineutrophil cytoplasmic antibody-associated vasculitis, a rare disorder affecting small vessels, primarily the respiratory tracts and the kidneys, with less common involvement of the central nervous system. Although posterior reversible encephalopathy syndrome (PRES) and intracranial hemorrhage (ICH) are documented complications, their concomitant occurrence in adults is extremely rare in this condition. We report a case of a 42-year-old Malay woman with heterozygous hemoglobin constant spring who presented with prolonged fever and recurrent severe anemia, posing a diagnostic dilemma. The diagnosis of GPA was confirmed through renal biopsy, and treatment was initiated. After a brief improvement, she developed status epilepticus secondary to concurrent PRES and ICH. This case highlights the diagnostic challenges of GPA and the rare, simultaneous occurrence of PRES and ICH, warranting careful therapeutic consideration due to both the disease and the treatment complications.

Keywords

License

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Case Report

ELECTRON J GEN MED, Volume 22, Issue 4, August 2025, Article No: em671

https://doi.org/10.29333/ejgm/16569

Publication date: 07 Jul 2025

Article Views: 54

Article Downloads: 31

Open Access References How to cite this article