{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T11:15:20Z","timestamp":1777979720986,"version":"3.51.4"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg\u2010Strauss vasculitis, is a rare systemic autoimmune disease. Neurological involvement is a significant complication. This report details a case of EGPA with severe, progressive polyneuropathy and atypical serological findings, highlighting diagnostic challenges and the importance of early intervention. A 55\u2010year\u2010old male with asthma and uncontrolled diabetes presented with progressive neuropathic pain and paraplegia. He had a history of significant eosinophilia. Clinical examination revealed a rash, neurological deficits, and signs of multisystem involvement. Laboratory tests showed marked eosinophilia, elevated inflammatory markers, renal impairment, and positive ANCA. Imaging revealed cerebral ischemic changes and small vessel vasculitis. A skin biopsy confirmed leukocytoclastic vasculitis, and echocardiography showed cardiac dysfunction. The constellation of symptoms led to a diagnosis of EGPA with multisystem involvement. This case illustrates the classic triad of EGPA symptoms: asthma, hypereosinophilia, and multisystem involvement, particularly neurological. The patient's progressive neurological symptoms and positive ANCA supported the diagnosis of CNS vasculitis. The rapid onset of neurological involvement, despite the patient's age and delayed diagnosis, underscores the aggressive nature of EGPA. The multisystem involvement, including cardiac and renal systems, highlights the need for a comprehensive diagnostic and therapeutic approach. Early diagnosis and aggressive immunosuppressive therapy are crucial for preventing irreversible damage. The atypical finding of c\u2010ANCA positivity, rather than the more common p\u2010ANCA, presents a diagnostic challenge and warrants further investigation into specific ANCA subtypes (MPO vs. PR3). This case emphasizes the need for a high index of suspicion for EGPA in patients with unexplained neurological symptoms, especially those with asthma or hypereosinophilia, even in the presence of unusual serological markers. EGPA is a complex disease with diverse neurological and systemic manifestations. This case emphasizes the importance of early recognition and prompt treatment with corticosteroids and immunosuppressive agents to improve patient outcomes and prevent long\u2010term sequelae. Clinicians should consider EGPA in patients with unexplained neurological symptoms, especially those with a history of asthma or hypereosinophilia.<\/jats:p>","DOI":"10.1002\/ccr3.72663","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T10:51:54Z","timestamp":1777978314000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Nerves to Vessels: Unmasking Churg\u2010Strauss Behind Polyneuropathy"],"prefix":"10.1002","volume":"14","author":[{"given":"Hiba","family":"Antar","sequence":"first","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences Lebanese University  Hadat Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvana","family":"Balhas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medical Sciences Lebanese University  Hadat Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6418-7132","authenticated-orcid":false,"given":"Zeinab","family":"El Mawla","sequence":"additional","affiliation":[{"name":"Department of Pulmonary &amp; Critical Care, Faculty of Medical Sciences Lebanese University  Hadat Lebanon"},{"name":"Department of Pulmonary &amp; Critical Care Lebanon Medical Center  Hadat Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"issue":"11","key":"e_1_2_12_2_1","first-page":"1051","article-title":"Eosinophilic Granulomatosis With Polyangiitis: An Overview","volume":"13","author":"Gioffredi A.","year":"2014","journal-title":"Autoimmunity Reviews"},{"key":"e_1_2_12_3_1","unstructured":"L.Silverstone \u201cEosinophilic Granulomatosis With Polyangiitis \u201d(2023) https:\/\/radiopaedia.org\/articles\/eosinophilic\u2010granulomatosis\u2010with\u2010polyangiitis."},{"issue":"12","key":"e_1_2_12_4_1","first-page":"1032","article-title":"Central Nervous System Involvement in Eosinophilic Granulomatosis With Polyangiitis (Churg\u2010Strauss): Report of 26 Patients and Review of the Literature","volume":"88","author":"Andr\u00e9 R.","year":"2017","journal-title":"Journal of Neurology, Neurosurgery & Psychiatry"},{"key":"e_1_2_12_5_1","volume-title":"StatPearls","author":"Chakraborty R. K.","year":"2023"},{"issue":"4","key":"e_1_2_12_6_1","first-page":"333","article-title":"Peripheral Nervous System Manifestations in Systemic Autoimmune Diseases","volume":"9","author":"Cojocaru I. M.","year":"2014","journal-title":"Maedica"},{"issue":"2","key":"e_1_2_12_7_1","first-page":"100","article-title":"Multiple Strokes and Cerebral Microangiopathy in a Patient With Churg\u2010Strauss Syndrome","volume":"20","author":"V\u0103c\u0103ra\u015f V.","year":"2021","journal-title":"Romanian Journal of Neurology"},{"issue":"31","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000034450","article-title":"ANCA\u2010Negative Eosinophilic Granulomatosis With Polyangiitis Complicated by Peripheral Nerve Damage: A Case Report","volume":"102","author":"Chen Y.","year":"2023","journal-title":"Medicine"},{"issue":"3","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.31138\/mjr.20230727.eg","article-title":"Eosinophilic Granulomatosis With Polyangiitis Presenting as Vasculitis in the Temporal Artery","volume":"34","author":"Kintrilis N.","year":"2023","journal-title":"Mediterranean Journal of Rheumatology"},{"issue":"4","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-236844","article-title":"Eosinophilic Granulomatosis With Polyangiitis: An Unusual Cause of Stroke","volume":"15","author":"Huckenpahler A. L.","year":"2022","journal-title":"BMJ Case Reports"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72663","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72663","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72663","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T10:51:58Z","timestamp":1777978318000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72663"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/ccr3.72663"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72663","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-07-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72663"}}