Multiple brain infarctions and endomyocarditis in ANCA-negative eosinophilic granulomatosis with polyangiitis

Figure 1. (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.