Eosinophilia and Thrombosis in Parasitic Diseases: An Overview

Abstract

It is known that peripheral blood eosinophilia (PBE) is a normal hematopoietic response to several parasitic diseases, but it is less known that PBE promotes a hypercoagulable state that may favor thrombosis. Scope of this article is to explore which parasitic infestations are most likely to be complicated by thrombosis and to highlight the pathogenetic contribution of PBE to vascular occlusions in this setting. A review of the world literature revealed 18 cases in which PBE was associated with vascular occlusion though no specific surveys were dedicated to this topic. The eosinophil exerts its thrombogenic potential by inhibition of the natural anticoagulant pathways and release of tissue factor with enhanced coagulation activation leading to vascular occlusion. It is hoped that this review contributes to the awareness of the link between PBE and thrombosis in parasitic disorders to foster research in this area.

Eosinophil-platelet interactions promote atherosclerosis and stabilize thrombosis with eosinophil extracellular traps

“…16 Eosinophilia in autoimmune diseases, parasitic infections, and hypereosinophilic syndrome is associated with increased risk of arterial thrombosis, which is a platelet-driven process. [62][63][64][65][66][67] In line with this, we found a stabilizing effect of eosinophils on thrombus formation in the setting of atherosclerosis. There, eosinophils accumulate in high numbers on the injured vessel wall.…”

Staphylococcus aureus Endocarditis as a Complication of Toxocariasis-Associated Endomyocarditis With Fibrosis: A Case Report

“…The clinical entity described in our patient is not only consistent with previous case reports [4, 5], but it can be explained by pathophysiological processes associated with toxocariasis [6–9]: as in idiopathic hypereosinophilic syndrome, infiltration of the myocardium by eosinophils leads to focal myocyte necrosis. The resulting fibrosis is a risk factor for subsequent thrombosis [6, 10].…”

“…The resulting fibrosis is a risk factor for subsequent thrombosis [6, 10]. In addition, peripheral blood eosinophilia caused by parasitic infections can cause hypercoagulable states, favoring thrombosis [9, 11]. The patient not only suffered from a right subclavian vein thrombosis when toxocariasis was first diagnosed, but he showed a growing apical thrombus despite full anticoagulation during the second bout of illness.…”

Chronic spontaneous urticaria and internal parasites – a systematic review

“…Two of these patients had an active phase of nematode infestation (strongyloidiasis and ascariasis) with blood eosinophilia level more than 3000 n/μl . Fifteen case reports were included in the review of Ames et al and showed peripheral blood eosinophilia and thrombosis in the course of a parasitic disease that implies the activation of the coagulation system. Opisthorchiasis and Schistosoma infections were accompanied by marked elevation of D‐dimer level and high thrombin generating potentials , but these phenomena were not observed in other PI .…”