To the Editor.—
I enjoyed reading the article "Multiple Sclerosis Associated With Eosinophilic Vasculitis, Pericarditis, and Hypocomplementemia" by Dr Tanphaichitr (Archives 1980 37:314-315). Either through oversight or perhaps through some confusion in terminology, the article did not mention polyarteritis as a possible cause for the patient's difficulties. I and my colleagues reported a case of a 16-year-old boy who had polyarteritis and in whom a multiple sclerosis like syndrome developed that affected the brainstem and cerebrum.' His serum demyelinated nerve in culture of tissue. A renal angiogram revealed multiple aneurysms that involved the peripheral branches of both renal arteries, mainly on the left side. Drs Mannik and Gilliland nicely reviewed the differential diagnosis of vasculitis.2 In my opinion, the neurological manifestations of both Dr Tanphaichitr's patient and my patient could all be attributed to vascular disease, and the multiple sclerosis picture to an "eosinophilic" herring.
Keith Meloff. Multiple Sclerosis and Polyarteritis. Arch Neurol. 1980;37(12):786. doi:10.1001/archneur.1980.00500610066015
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