Mystery Case: Diagnostic challenges in a young patient with hypereosinophilia

Ortiz, Jorge G.; Douglas, Preston; Gill, Chandler E.; Mehrotra, Swati; Biller, José

doi:10.1212/wnl.0000000000004413

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…The presence of four or more of these criteria yielded a sensitivity of 85.0% and specificity of 99.7%. 9 Our patient met four of these criteria: asthma, eosinophilia of >10%, peripheral neuropathy, and vasculitis with extravascular eosinophils confirmed by skin biopsy. Asthma is the major manifestation of EGPA, affecting 91% to 100% of patients and often appearing before the systemic vasculitis.…”

Section: Discussionmentioning

confidence: 75%

Budd–Chiari syndrome as a complication of eosinophilic granulomatosis with polyangiitis in a young Chinese man: a case report

Shi

Ding

et al. 2020

J Int Med Res

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Hepatic vein thrombosis is a rare occurrence in the clinical course of eosinophilic granulomatosis with polyangiitis (EGPA). The major mechanism of thrombosis has been postulated to involve the release of toxic proteins from eosinophils. A 36-year-old man with EGPA was admitted to our hospital in July 2018 with hematemesis and melena. Findings on physical examination included ascites and pigmentation of the lower extremities. Ultrasonography of the hepatic vein and inferior vena cava showed an obstruction of the hepatic vein. Magnetic resonance imaging showed low enhancement in the right hepatic vein region. At 34 years of age, the patient’s EGPA had initially presented as asthma with eosinophilia (white blood cell count of 11.46 × 1012/L with 14.6% eosinophils). His skin biopsy showed infiltration of inflammatory cells and eosinophils, especially around medium-sized vessels, which was consistent with EGPA. The patient was thus diagnosed with Budd–Chiari syndrome associated with EGPA.

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Section: Discussionmentioning

confidence: 75%