Association of Thrombosis With Hypereosinophilic Syndrome in Patients With Genetic Alterations

Leiva, Orly; Baker, Olesya; Jenkins, Andrew; Brunner, Andrew M.; Al‐Samkari, Hanny; Leaf, Rebecca Karp; Rosovsky, Rachel; Fathi, Amir T.; Weitzman, James; Bornikova, Larissa; Nardi, Valentina; Hobbs, Gabriela

doi:10.1001/jamanetworkopen.2021.19812

Cited by 18 publications

(22 citation statements)

References 25 publications

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“…Additionally, in patients with idiopathic hypereosinophilic syndrome (a heterogeneous disorder characterized by proliferation of potentially neoplastic eosinophils), mutations in CHIP-associated genes indicate an increased risk for thrombotic events. 30 However, cardiovascular implications related to nondriver mutations have not been well characterized in the MPN population. In a small study of 16 patients with polycythemia vera, the presence of TET2 , DNMT3A , or ASXL1 mutations was associated with increased risk for thrombotic events.…”

Section: Influence Of Driver Mutations and Chip-associated Mutations ...mentioning

confidence: 99%

Cardiovascular Disease in Myeloproliferative Neoplasms

Leiva

Hobbs

Ravid

et al. 2022

JACC: CardioOncology

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Section: Influence Of Driver Mutations and Chip-associated Mutations ...mentioning

confidence: 99%

Cardiovascular Disease in Myeloproliferative Neoplasms

Leiva

Hobbs

Ravid

et al. 2022

JACC: CardioOncology

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“…31,32 Additionally, rare inherited hypereosinophyllic syndromes have been associated with increased thrombotic risk. 33 Our study has many strengths, including the size of the cohort and the detailed CAD phenotyping by CTCA. However, there were some limitations.…”

Section: How Representative Are Our Findings To Global Cardiovascular...mentioning

confidence: 99%

Immunoglobulin E Sensitization to Mammalian Oligosaccharide Galactose-α-1,3 (α-Gal) Is Associated With Noncalcified Plaque, Obstructive Coronary Artery Disease, and ST-Segment–Elevated Myocardial Infarction

Vernon

Kott

Hansen

et al. 2022

ATVB

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Background: Treating known risk factors for coronary artery disease (CAD) has substantially reduced CAD morbidity and mortality. However, a significant burden of CAD remains unexplained. Immunoglobulin E sensitization to mammalian oligosaccharide galactose-α-1,3-galactose (α-Gal) was recently associated with CAD in a small observational study. We sought to confirm that α-Gal sensitization is associated with CAD burden, in particular noncalcified plaque. Additionally, we sort to assess whether that α-Gal sensitization is associated with ST-segment–elevated myocardial infarction (STEMI) Methods: We performed a cross-sectional analysis of participants enrolled in the BioHEART cohort study. We measured α-Gal specific-immunoglobulin E antibodies in serum of 1056 patients referred for CT coronary angiography for suspected CAD and 100 selected patients presenting with STEMI, enriched for patients without standard modifiable risk factors. CT coronary angiograms were assessed using coronary artery calcium scores and segmental plaque scores. Results: α-Gal sensitization was associated with presence of noncalcified plaque (odds ratio, 1.62 [95% CI, 1.04–2.53], P =0.03) and obstructive CAD (odds ratio, 2.05 [95% CI, 1.29-3.25], P =0.002), independent of age, sex, and traditional risk factors. The α-Gal sensitization rate was 12.8-fold higher in patients with STEMI compared with matched healthy controls and 2.2-fold higher in the patients with STEMI compared with matched stable CAD patients (17% versus 1.3%, P =0.01 and 20% versus 9%, P =0.03, respectively). Conclusions: α-Gal sensitization is independently associated with noncalcified plaque burden and obstructive CAD and occurs at higher frequency in patients with STEMI than those with stable or no CAD. These findings may have implications for individuals exposed to ticks, as well as public health policy. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: ACTRN12618001322224.

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“…Although the precise mechanism of eosinophil‐induced hypercoagulability is still unclear, contributing factors probably include initiation of the clotting cascade by expression of tissue factor, endothelial injury by major basic protein (MBP), stimulation of thrombus formation by binding to heparin and neutralizing its anticoagulating effects by eosinophilic cationic protein 7,8 . Data regarding the risk of thrombosis due to eosinophilia is limited to case reports and a small cohort study that showed that within a 29‐month follow‐up, 24% of the included patients, had one or more thrombotic events 9 . Antiphospholipid syndrome (APS) is associated with an increased risk of thrombosis which is medicated by impairment of fibrinolysis, reduction in protein C activity, procoagulant effects on platelets and endothelial cells, and induction of vascular endothelial growth factor (VEGF) 2,3,10 .…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Data regarding the risk of thrombosis due to eosinophilia is limited to case reports and a small cohort study that showed that within a 29-month follow-up, 24% of the included patients, had one or more thrombotic events. 9 Antiphospholipid syndrome (APS) is associated with an increased risk of thrombosis which is medicated by impairment of fibrinolysis, reduction in protein C activity, procoagulant effects on platelets and endothelial cells, and induction of vascular endothelial growth factor (VEGF). 2,3,10 Diagnosis of APS is done by revised Sapporo classification criteria which include clinical criteria (vascular thrombosis and pregnancy morbidity) and laboratory criteria: LA, aCL, and anti-β2 glycoprotein I antibodies.…”

Section: Case Presentationmentioning

confidence: 99%

Bilateral pulmonary embolism associated with peripheral blood eosinophilia and positive antiphospholipid antibodies in a patient with cellulitis

Tun

Kyaw²,

Chernikova

et al. 2023

Clinical Case Reports

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Key Clinical Message This report described the pathophysiology, diagnostic workup, and management of thrombosis possibly associated with peripheral blood eosinophilia and transient positive antiphospholipid antibodies in the setting of cellulitis. Abstract Peripheral blood eosinophilia is a risk factor for thrombosis and the presence of other prothrombotic factors such as antiphospholipid antibodies can potentiate that risk. The authors present a case of acute pulmonary embolism which developed at the peak of eosinophilia, later found to have transient positive antiphospholipid antibodies in a male patient with right lower limb cellulitis and a history of intravenous drug abuse. This report illustrates the pathophysiology, diagnosis workup, and therapeutic options of thrombosis possibly associated with peripheral blood eosinophilia and positive antiphospholipid antibodies, which include anticoagulants, corticosteroids, and immunosuppressants. Clinicians should be aware of this possible association which may guide the choice and duration of anticoagulants. Although direct oral anticoagulants are effective anticoagulants in various thromboembolic events, studies showed unfavorable outcomes for their use in antiphospholipid syndrome.

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Association of Thrombosis With Hypereosinophilic Syndrome in Patients With Genetic Alterations

Cited by 18 publications

References 25 publications

Cardiovascular Disease in Myeloproliferative Neoplasms

Cardiovascular Disease in Myeloproliferative Neoplasms

Immunoglobulin E Sensitization to Mammalian Oligosaccharide Galactose-α-1,3 (α-Gal) Is Associated With Noncalcified Plaque, Obstructive Coronary Artery Disease, and ST-Segment–Elevated Myocardial Infarction

Bilateral pulmonary embolism associated with peripheral blood eosinophilia and positive antiphospholipid antibodies in a patient with cellulitis

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