Idiopathic Hypereosinophilic Syndrome Associated with Multiple Intracardiac Thrombi

Abstract

A 17-year-old man was referred for dyspnea, fatigue, and fever. Idiopathic hypereosinophilic syndrome was diagnosed. Transthoracic echocardiography demonstrated multiple intracardiac thrombi in the left ventricular apex. Dissolution of thrombi was not seen despite intensive medical therapy. The patient died because of cerebral embolus.

Eosinophilia: secondary, clonal and idiopathic

“…In essence, therefore, any organ is vulnerable to eosinophilia‐associated tissue damage although the major tissue targets are the heart, the nervous system, the skin and the upper and lower respiratory tract including the lung parenchyma. In addition, thromboembolic disease involving the cardiac chambers (Kocaturk & Yilmaz, 2005) as well as both venous (Liao et al , 2005) and arterial (Ponsky et al , 2005) vessels are not infrequent.…”

Superficial Venous Thrombophlebitis as the Initial Manifestation of Hypereosinophilic Syndrome

“…Among these various risk factors, eosinophilia has been reported during vasculitis, malignant blood disorders, and solid tumors. Hypereosinophilic syndrome (HES) has been associated with various thrombotic manifestations such as portal thrombosis, 1 deep venous thrombosis, 2,3 cerebral venous thrombosis, 4 Budd-Chiari syndrome, 5 hepatic venoocclusive disease, 6 or intracardiac thrombi, 7 but SVT has never been described.…”

Rezidivierende transitorische ischämische Attacken bei einer Patientin mit Pansinusitis

“…Jedoch liegt eine Beteiligung des zentralen und peripheren Nervensystems beim HES häufig vor, meistens in Form von Enzephalopathien, Polyneuropathien und Hirninfarkten [6]. Zerebrale Ischämien können einerseits durch eine Verschleppung kardialer Mikroemboli entstehen, vor allem bei linksventrikulären Spitzenthrombi oder als paradoxe Embolie [4]. Andererseits kann eine direkte eosinophile ZNS-Infiltration beim HES durch die Toxizi-…”