Acute pulmonary embolism and deep vein thrombosis secondary to idiopathic hypereosinophilic syndrome

Li, Dezhi; Xu, Li; Dong, Lin; Jiang, Shujuan; Feng, Saran; Zhu, Ling

doi:10.1016/j.rmcr.2018.09.006

Cited by 13 publications

(19 citation statements)

References 15 publications

(15 reference statements)

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“…Recently, gastrointestinal involvement was also recognized as the one and only poor prognostic factor in PAN (15). Another study of systemic necrotizing vasculitis with surgical abdomen found that eosinophilia was reported in 0 of 12 PAN cases, in marked contrast to its observation in all 4 cases of EGPA (10). To our knowledge, marked eosinophilia in gastrointestinal PAN, as seen in our case, has not been reported, and only one case of HES with necrotizing vasculitis in the skin and the small intestine, resulting in bowel perforation, has been reported (2).…”

Section: Discussionmentioning

confidence: 94%

Polyarteritis Nodosa with Marked Eosinophilia, Associated with Severe Gastrointestinal Tract Involvement and Recurrent Venous Thrombosis

et al. 2019

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A 45-year-old man was admitted with acute abdominal pain and eosinophilia. Abdominal computed tomography revealed thickness of the ascending and transverse colon with decreased contrast enhancement and a small amount of ascites. In an emergency operation, the necrotic colon was resected. Histopathology showed subserous medium-sized arteritis with abundant eosinophil infiltrates and thrombosis in the portal vein branches. He was diagnosed with polyarteritis nodosa (PAN), and immunosuppressive therapy improved his condition. Two years later, the disease recurred with ischemic cutaneous lesions and marked eosinophilia. Our experience suggests that marked eosinophilia in PAN may imply severe organ involvement, including gastrointestinal necrosis, as well as the association of venous thrombosis.

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Section: Discussionmentioning

confidence: 94%

Polyarteritis Nodosa with Marked Eosinophilia, Associated with Severe Gastrointestinal Tract Involvement and Recurrent Venous Thrombosis

et al. 2019

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“…Usually, skin symptoms such as urticaria or eczema or digestive symptoms such as nausea, vomiting, and diarrhea or respiratory symptoms such as asthma are the most common symptoms described by patients, but thromboses are not rare, comprising 20% or more of affected patients. 5,6 These symptoms may also be present in clonal eosinophilia and may be associated with peripheral nervous dysfunctions or thromboembolic complications. 8 Venous thromboembolism is the one of the most commonly described thromboses in hypereosinophilia and it may influence long-term treatment and prognosis of hypereosinophilic patients.…”

Section: Discussionmentioning

confidence: 99%

“…8 Venous thromboembolism is the one of the most commonly described thromboses in hypereosinophilia and it may influence long-term treatment and prognosis of hypereosinophilic patients. 5,6 Several pathophysiological mechanisms have been described in the last decades to explain the hypercoagulable state induced by hypereosinophilia that may lead to thrombosis. Of course the most commonly known has been related to chronic inflammation as in the Churg-Strauss vasculitis that may cause a real thromboangiitis.…”

Section: Discussionmentioning

confidence: 99%

“…5 Thrombotic complications may occur in several regions and venous thromboembolism (VTE) is one of the most common clinical thrombotic complications associated with hypereosinophilia. 5,6 Little is known from a pathophysiological point of view concerning the generation of a prothrombotic condition induced by hypereosinophilia but other environmental prothrombotic risk factors may occur in each patient with hypereosinophilia as far as a possible association with inherited thrombophilia or hormonal treatment or pregnancy or recent hypomobility or recent surgery. 7 We report a clinical case in which an adult without personal and familial history of VTE but with chronic hypereosinophilia developed a sudden VTE without association with further environmental thrombotic risk factors, suggesting a possible direct link between hypereosinophilic conditions and venous thromboembolism.…”

Section: Introductionmentioning

confidence: 99%

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<p>Idiopathic Hypereosinophilia and Venous Thromboembolism: Is There a Pathophysiological or Clinical Link? Description of an Intriguing Clinical Case</p>

Micco

Scudiero

Lombardo

et al. 2020

JBM

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Thrombosis events usually occur after prolonged bedrest, pregnancy, hormonal therapy, recent surgery and in the presence of inherited or acquired thrombophilia. However, several other diseases are often associated with thrombosis although their frequency is not easily estimated. Eosinophilia is one of these conditions. From a clinical viewpoint it is very difficult to understand which conditions might lead to a thrombotic event because the underlying pathophysiological mechanisms are different. Here, we report a case of idiopathic hypereosinophilia associated to venous thromboembolism without any other associated prothrombotic condition.

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“…Because of the rarity and nonspecific clinical features of IHE/HES, available data on thromboembolism in patients with these disorders are limited and sporadic. Information on the clinical features and outcomes of these conditions is also limited 11 . To better understand the thromboembolic complications of HE, this case series summarises the patient demographics, clinical features, and short-term clinical outcomes in patients with IHE/ HES and concurrent VTE.…”

mentioning

confidence: 99%

Hypereosinophilia with Concurrent Venous Thromboembolism: Clinical Features, Potential Risk Factors, and Short-term Outcomes in a Chinese Cohort

Liu

Meng

Feng

et al. 2020

Sci Rep

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idiopathic hypereosinophilia (iHe) and hypereosinophilic syndrome (HeS) are benign haematological disorders. Studies have suggested that venous thromboembolism (Vte) is a rare but sometimes fatal complication of hypereosinophilia; however, data are limited. We retrospectively analysed clinical features and short-term outcomes of 63 consecutive patients (82.5% men; mean age, 40.92 ± 10.89 years) with IHE or HES with concurrent VTE from January 1998 through December 2018. Risk factors for pulmonary embolism (PE) were explored by multivariate logistic analysis. DVT and/or PE was detected by imaging in all patients. independent risk factors for pe were a body mass index of >24.1 kg/m 2 (odds ratio [OR]: 5.62, 95% confidence interval [CI]: 1.21-26.13, P = 0.028), peak absolute eosinophil count of >6.3 × 10 9 /L (OR: 5.55, 95% CI: 1.292-23.875, P = 0.021), and >13.9-month duration of hypereosinophilia (OR: 4.51, 95% CI: 1.123-18.09, P = 0.034). All patients were treated with corticosteroids and anticoagulants. The short-term hypereosinophilia remission rate was 100%; no recurrent Vte or major bleeding was observed. Hypereosinophilia is a potential risk factor for Vte. pe in patients with IHE/HES and DVT is associated with a higher body mass index, higher peak absolute eosinophil count, and longer duration of hypereosinophilia. corticosteroids and anticoagulants provided effective short-term control of hypereosinophilia and VTE. Hypereosinophilia (HE) encompasses a diverse group of disorders characterised by peripheral blood eosinophilia (>1.5 × 10 9 /L) with or without a primary cause (such as haematologic, autoimmune, parasitic, or allergic disease) 1. Idiopathic HE (IHE) is HE without a primary aetiology or organ damage. When HE without a primary aetiology induces organ damage, it is termed hypereosinophilic syndrome (HES). Damage to various organs has been reported in patients with IHE and HES, most commonly dermal, lung, cardiovascular, and gastrointestinal system damage. Venous thromboembolism (VTE) is a rare complication of HE 1,2. Previous studies have focused on thrombus formation in patients with IHE/HES 3. A few studies have suggested that approximately 25% of patients with HES develop thromboembolic complications, with an associated mortality rate of 5% to 10% 2. Many types of thrombosis have been reported, including mural thrombus of the heart, inferior vena cava (IVC) thrombosis, superficial venous thrombosis, portal thrombosis, deep venous thrombosis (DVT) with or without pulmonary embolism (PE), cerebral arteriolar and venous thrombosis, and intracardiac thrombi 2,4-10. Among these, DVT with PE is a rare but often fatal complication of HES 11. Because most reported cases lacked primary aetiologies and traditional risk factors for VTE, we hypothesised that HE may cause development of VTE.

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Acute pulmonary embolism and deep vein thrombosis secondary to idiopathic hypereosinophilic syndrome

Cited by 13 publications

References 15 publications

Polyarteritis Nodosa with Marked Eosinophilia, Associated with Severe Gastrointestinal Tract Involvement and Recurrent Venous Thrombosis

Polyarteritis Nodosa with Marked Eosinophilia, Associated with Severe Gastrointestinal Tract Involvement and Recurrent Venous Thrombosis

<p>Idiopathic Hypereosinophilia and Venous Thromboembolism: Is There a Pathophysiological or Clinical Link? Description of an Intriguing Clinical Case</p>

Hypereosinophilia with Concurrent Venous Thromboembolism: Clinical Features, Potential Risk Factors, and Short-term Outcomes in a Chinese Cohort

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