Idiopathic Hypereosinophilic Syndrome Presenting With Embolic Stroke

Silva, Magda S.; Ramalho, Carina; Ferreira, Francelino; Maia, Inês; Joosten, Anneke

doi:10.7759/cureus.19307

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Mostly, the HIS cases are described all around the world with mainly cardiac and gastrointestinal involvement [ 1 ]. In addition, there are some case reports of patients with HES presenting with embolic stroke [ 7 ]. In our case, the patient only presented with lymphadenopathy with skin manifestations therefore the absence of gastrointestinal, lung, and cardiac involvement doesn’t necessarily discourage the diagnosis of IHS.…”

Section: Discussionmentioning

confidence: 99%

A Diagnosis of Idiopathic Hypereosinophilic Syndrome With Skin Involvement in a Patient Presenting With Lymphadenopathy and Rash

Nishanth¹,

Umakanth²

2022

Cureus

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Idiopathic hypereosinophilic syndrome is a rare entity where the diagnosis is made after all the probable causes of hypereosinophilia are excluded. The characteristic organ involvement includes the heart, nervous system, lung, and gastrointestinal tract. The mainstay of treatment is corticosteroids. Patients who are unresponsive to the steroids require immunomodulatory therapy that includes imatinib, mepolizumab, and in some resistant cases alemtuzumab. We describe a case of idiopathic hypereosinophilic syndrome with skin involvement without other organ infiltration in a previously unevaluated South Asian male who responded well to the initiation of steroid therapy.

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Section: Discussionmentioning

confidence: 99%

A Diagnosis of Idiopathic Hypereosinophilic Syndrome With Skin Involvement in a Patient Presenting With Lymphadenopathy and Rash

Nishanth¹,

Umakanth²

2022

Cureus

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Development of Henoch-Schoenlein purpura in a child with idiopathic hypereosinophilia syndrome with multiple thrombotic onset: A case report

Xu¹,

Xiao-bi²,

Wang³

et al. 2023

World J Clin Cases

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BACKGROUND The incidence of pulmonary embolism (PE) in children is low, but its mortality is high. Hypereosinophilic syndrome (HES) is a group of diseases caused by an abnormal increase in eosinophilic granulocytes resulting in multiple-organ dysfunction. The urgent event of thromboembolism in the pulmonary region provoked by eosinophils in idiopathic HES (IHES) is relatively unusual. This article reports a case of IHES with multiple PEs and left leg venous thrombosis as the first manifestation. One month later, the patient developed Henoch-Schonlein purpura (HSP), which is very rare. CASE SUMMARY We report the case of a 12-year-old boy who was admitted to the hospital with dyspnea, left leg pain, and aggravation. He had bilateral PE and left leg venous embolism with mild eosinophilia. Low-molecular-weight heparin and urokinase were given. At the same time, the interventional department was contacted about filter implantation, followed by urokinase thrombolysis. The left leg thrombus was aspirated under ultrasound guidance. He was discharged from the hospital on rivaroxaban. One month later, he developed a rash on both legs and ankle pain consistent with HSP, with severe eosinophilia and motor and sensory disturbances. The patient was diagnosed with IHES with multiple embolisms complicated by HSP after excluding other causes of the eosinophil elevation. After glucocorticoid treatment, the symptoms were relieved, but the patient later developed purpura nephritis. CONCLUSION We report a rare and life-threatening case of IHES with multiple embolisms associated with HSP. A mild elevation of eosinophils early in the disease leads to difficulties in diagnosis and delayed treatment.

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Idiopathic Hypereosinophilic Syndrome Presenting With Embolic Stroke

Cited by 2 publications

References 14 publications

A Diagnosis of Idiopathic Hypereosinophilic Syndrome With Skin Involvement in a Patient Presenting With Lymphadenopathy and Rash

A Diagnosis of Idiopathic Hypereosinophilic Syndrome With Skin Involvement in a Patient Presenting With Lymphadenopathy and Rash

Development of Henoch-Schoenlein purpura in a child with idiopathic hypereosinophilia syndrome with multiple thrombotic onset: A case report

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