Hypereosinophilic syndrome presenting as coagulopathy
Abstract Background Hypereosinophilic syndrome (HES) is an extremely uncommon group of disorders. It rarely presents with coagulopathy without cardiac involvement. Case presentation A 33-year-old previously healthy male with no history of atopic disease presented with abdominal pain, hematochezia, p...
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | Allergy, Asthma & Clinical Immunology |
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| Online Access: | https://doi.org/10.1186/s13223-022-00666-2 |
| _version_ | 1818358041822625792 |
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| author | Kestutis Aukstuolis Jocelyn J. Cooper Katherine Altman Anna Lang Andrew G. Ayars |
| author_facet | Kestutis Aukstuolis Jocelyn J. Cooper Katherine Altman Anna Lang Andrew G. Ayars |
| author_sort | Kestutis Aukstuolis |
| collection | DOAJ |
| description | Abstract Background Hypereosinophilic syndrome (HES) is an extremely uncommon group of disorders. It rarely presents with coagulopathy without cardiac involvement. Case presentation A 33-year-old previously healthy male with no history of atopic disease presented with abdominal pain, hematochezia, peripheral eosinophilia as high as 10,000 eos/µL, right and left portal vein, mesenteric, and splenic vein thrombi with ischemic colitis resulting in hemicolectomy and small bowel resection. Despite an extensive workup for primary and secondary etiologies of hypereosinophilia by hematology/oncology, infectious disease, rheumatology and allergy/immunology, no other clear causes were identified, and the patient was diagnosed with idiopathic HES. His eosinophilia was successfully treated with high-dose oral corticosteroids (OCS) and subsequently transitioned to anti-IL-5-receptor therapy with benralizumab. He has continued this treatment for over a year with no recurrence of eosinophilia or thrombosis while on benralizumab. Conclusion In patients with an unexplained coagulopathy and eosinophilia, eosinophilic disorders such as HES should be considered. Corticosteroid-sparing agents, such as benralizumab show promise for successfully treating these patients. |
| first_indexed | 2024-12-13T20:22:42Z |
| format | Article |
| id | doaj.art-73b0a379430a4604acae1ae96e0e6d8b |
| institution | Directory Open Access Journal |
| issn | 1710-1492 |
| language | English |
| last_indexed | 2024-12-13T20:22:42Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Allergy, Asthma & Clinical Immunology |
| spelling | doaj.art-73b0a379430a4604acae1ae96e0e6d8b2022-12-21T23:32:38ZengBMCAllergy, Asthma & Clinical Immunology1710-14922022-03-011811510.1186/s13223-022-00666-2Hypereosinophilic syndrome presenting as coagulopathyKestutis Aukstuolis0Jocelyn J. Cooper1Katherine Altman2Anna Lang3Andrew G. Ayars4Division of Allergy and Infectious Diseases, Department of Medicine, University of WashingtonDivision of Internal Medicine, Department of Medicine, University of WashingtonDivision of Allergy and Infectious Diseases, Department of Medicine, University of WashingtonDivision of Allergy and Infectious Diseases, Department of Medicine, University of WashingtonDivision of Allergy and Infectious Diseases, Department of Medicine, University of WashingtonAbstract Background Hypereosinophilic syndrome (HES) is an extremely uncommon group of disorders. It rarely presents with coagulopathy without cardiac involvement. Case presentation A 33-year-old previously healthy male with no history of atopic disease presented with abdominal pain, hematochezia, peripheral eosinophilia as high as 10,000 eos/µL, right and left portal vein, mesenteric, and splenic vein thrombi with ischemic colitis resulting in hemicolectomy and small bowel resection. Despite an extensive workup for primary and secondary etiologies of hypereosinophilia by hematology/oncology, infectious disease, rheumatology and allergy/immunology, no other clear causes were identified, and the patient was diagnosed with idiopathic HES. His eosinophilia was successfully treated with high-dose oral corticosteroids (OCS) and subsequently transitioned to anti-IL-5-receptor therapy with benralizumab. He has continued this treatment for over a year with no recurrence of eosinophilia or thrombosis while on benralizumab. Conclusion In patients with an unexplained coagulopathy and eosinophilia, eosinophilic disorders such as HES should be considered. Corticosteroid-sparing agents, such as benralizumab show promise for successfully treating these patients.https://doi.org/10.1186/s13223-022-00666-2Hypereosinophilic syndromeThrombosisBowel perforationAnti-IL-5-receptor therapyBenralizumabIschemic colitis |
| spellingShingle | Kestutis Aukstuolis Jocelyn J. Cooper Katherine Altman Anna Lang Andrew G. Ayars Hypereosinophilic syndrome presenting as coagulopathy Allergy, Asthma & Clinical Immunology Hypereosinophilic syndrome Thrombosis Bowel perforation Anti-IL-5-receptor therapy Benralizumab Ischemic colitis |
| title | Hypereosinophilic syndrome presenting as coagulopathy |
| title_full | Hypereosinophilic syndrome presenting as coagulopathy |
| title_fullStr | Hypereosinophilic syndrome presenting as coagulopathy |
| title_full_unstemmed | Hypereosinophilic syndrome presenting as coagulopathy |
| title_short | Hypereosinophilic syndrome presenting as coagulopathy |
| title_sort | hypereosinophilic syndrome presenting as coagulopathy |
| topic | Hypereosinophilic syndrome Thrombosis Bowel perforation Anti-IL-5-receptor therapy Benralizumab Ischemic colitis |
| url | https://doi.org/10.1186/s13223-022-00666-2 |
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