PMC9860291_01
(A, B) Magnetic resonance imaging (MRI) upon admission. Diffusion-weighted MRI showed multiple infarctions in bilateral cerebrum and right cerebellum. (C) Transthoracic echocardiographic view. The high echogenicity of the endocardium in the interventricular septum and left ventricular inferior wall corresponded to areas of fibrosis (arrow). (D) The left ventricular global longitudinal strain was impaired in the interventricular septum and left ventricular inferior wall. (E) Cardiac MRI showed delayed enhancement in the interventricular septum and inferior endocardium (arrowheads). (F) Skin biopsy with hematoxylin and eosin staining revealed leukocytoclastic vasculitis accompanied by eosinophilic infiltration of the small vessels.
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Brain magnetic resonance imaging (MRI) revealed multiple cerebral and cerebellar infarctions (Fig. 1A and B). Transthoracic echocardiography revealed increased endocardial brightness in the interventricular septum and left ventricular inferior wall, and the left ventricular global longitudinal strain (GLS) was impaired (Fig. 1C and D). Cardiac MRI showed delayed endocardial enhancement in the same area (Fig. 1E). Skin biopsy showed eosinophilic vasculitis, consistent with EGPA (Fig. 1F).