Recurrent Abdominal Thrombosis Despite Heparin Thromboprophylaxis in a Patient With Transient Eosinophilia

Ames, P.R.J.

doi:10.1177/1076029609343450

Cited by 9 publications

(9 citation statements)

References 12 publications

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“…In addition, cases of thrombosis in patients with transient eosinophilia have been reported (3)(4)(5)(6)(7)(8)(9). In the present report, we describe a case of cerebral sinovenous thrombosis associated with transient eosinophilia; to our knowledge, no such case has previously been reported in the literature.…”

Section: Introductionmentioning

confidence: 54%

Cerebral Sinovenous Thrombosis in a Patient with Transient Eosinophilia

et al. 2014

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A 67-year-old man with a history of prostatic hypertrophy developed behavioral anomalies and a fever. At admission, diffusion-weighted brain magnetic resonance imaging (MRI) indicated a high-intensity signal lesion on both sides of the cerebral hemisphere. Immediately after hospitalization, he developed paralysis of the left side of the body. Diffusion-weighted MRI indicated hemorrhagic changes in the right and left parietal lobes and right occipital lobe. Magnetic resonance venography indicated superior sagittal sinus occlusion. The blood test results indicated transient eosinophilia. Cases of thrombosis with idiopathic eosinophilia have been reported, but this is the first known case of cerebral sinus thrombosis with transient eosinophilic leukocytosis.

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Section: Introductionmentioning

confidence: 54%

Cerebral Sinovenous Thrombosis in a Patient with Transient Eosinophilia

et al. 2014

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“…In numerous prior reports, venous and/or arterial thromboembolism is found associated with peripheral blood eosinophilia, mostly hypereosinophilia that shows abnormally high eosinophil counts and lasts for longer than 6 months, in a variety of disorders including idiopathic hypereosinophilia without organ damage, hypereosinophilic syndrome, Churg-Strauss syndrome and parasitic diseases [10][11][12]. Transient eosinophilia less than 6 months of duration has also been reported related to venous thromboembolism presenting with multivessel involvement including portal venous system in teenaged and adult patients [13,14,[33][34][35]. The hypereosinophilia of these patients was idiopathic (without a primary cause) or secondary to conditions leading to eosinophilia, ranged from 1600 to 9350 cells/mm 3 of absolute eosinophil counts, and was largely associated with thrombocytopenia, remitting with resolved thrombi after multimodal treatments including anticoagulants, thrombolytics, and corticosteroids [13,14,[33][34][35].…”

Section: Discussionmentioning

confidence: 96%

“…In neonates, although most of neonates with eosinophilia present solely with mild eosinophilia [2], previous reports have shown various associated conditions with eosinophilia including food hypersensitivity encompassing cow's milk allergy (CMA) and food proteininduced allergic proctocolitis (FPIAP), drug reactions, infection/sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, hypereosinophilic syndrome, and eosinophilic leukemia [8,[1][2][3], with some evidence of elevated eosinophil counts as a predictive marker of atopic disease development [9]. Furthermore, blood eosinophilia has been proposed as a possible risk factor for venous thromboembolism in prior reports showing possible links between eosinophilia and a prothrombotic state or thrombosis [10][11][12][13][14]. However, few reports are found on thromboembolic events including portal vein thrombosis (PVT) associated with eosinophilia in the newborn period.…”

Section: Introductionmentioning

confidence: 99%

Portal vein thrombosis and food protein-induced allergic proctocolitis in a premature newborn with hypereosinophilia: a case report

2021

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Background Peripheral blood eosinophilia is identified in numerous medical conditions associated with allergic, infectious, and inflammatory processes mostly as reactive eosinophilia with or without tissue eosinophilia. In hospitalized neonates, eosinophilia is common with an inverse relationship with gestational age and occurs solely as mild eosinophilia in the majority of cases. In the literature, eosinophilia has been proposed as a possible risk factor for venous thromboembolism. However, few reports are found on thromboembolic events including portal vein thrombosis (PVT) associated with eosinophilia in the newborn period. Neonates, particularly preterm infants, are vulnerable to thrombosis due to the immature and developing hemostatic system with little reserve capacity, which occurs as catheter-related thrombosis in most cases. Case presentation A male newborn at 34+ 5 weeks’ gestation presented with a left portal venous thrombus and hematochezia after initial cow’s milk feeding in the setting of blood hypereosinophilia for a prolonged period of time without central venous catheterization. The infant was diagnosed with PVT and food protein-induced allergic proctocolitis (FPIAP) and showed complete resolution of the conditions with expectant management with food avoidance, including the normalized eosinophil count. Conclusions Our experience suggests that in the setting of hypereosinophilia with a prolonged duration in premature neonates, FPIAP should be suspected in case of hematochezia in otherwise healthy infants, and considering the increased thrombotic risk by the hypereosinophilia and premature newborn status, evaluation for neonatal thrombosis may be needed, including PVT with the potential risk for the more serious, but uncommon, late complications encompassing portal hypertension.

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“…Additionally, inflammation raises levels of fibrinogen and platelets, contributing to hypercoagulability [10,11] . There are reports of severe thromboembolic events involving the portal vein in cases of transient eosinophilia [12–14] , so eosinophilia itself is a risk factor for thromboembolism [15] .…”

Section: Discussionmentioning

confidence: 99%

Portal Vein Thrombosis and Thrombocytopenia in Eosinophilic Granulomatosis with Polyangiitis: A Paradox?

Wolf

Glick

Elias

et al. 2018

European Journal of Case Reports in Internal Medicine

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A 36-year-old woman with eosinophilic granulomatosis with polyangiitis (EGPA) presented with necrotic skin lesions and pulmonary infiltrates. There was eosinophilic vasculitis on skin biopsy, and substantial tissue eosinophilia in her bone marrow. She had unexplained worsening thrombocytopenia, which prompted a thrombophilia work-up. However, abnormalities in liver enzymes led to the extraordinary finding of portal vein thrombosis. Thrombocytopenia resolved with treatment with low molecular weight heparin. This case highlights the risk of hypercoagulability in eosinophilia specifically, and in EGPA. We suggest that thrombosis should be ruled out in all cases of EGPA.LEARNING POINTSEosinophilia is a hypercoagulable state.Thrombocytopenia is not part of eosinophilic granulomatosis with polyangiitis (EGPA) and may herald thrombosis.Thromboembolism should be ruled out in the setting of EGPA with eosinophilia.Prompt diagnosis can prevent unnecessary procedures.

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Recurrent Abdominal Thrombosis Despite Heparin Thromboprophylaxis in a Patient With Transient Eosinophilia

Cited by 9 publications

References 12 publications

Cerebral Sinovenous Thrombosis in a Patient with Transient Eosinophilia

Cerebral Sinovenous Thrombosis in a Patient with Transient Eosinophilia

Portal vein thrombosis and food protein-induced allergic proctocolitis in a premature newborn with hypereosinophilia: a case report

Portal Vein Thrombosis and Thrombocytopenia in Eosinophilic Granulomatosis with Polyangiitis: A Paradox?

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