Allergy Asthma Immunol Res.  2012 May;4(3):161-164. 10.4168/aair.2012.4.3.161.

A Case of Hypereosinophilic Syndrome Presenting With Multiorgan Infarctions Associated With Disseminated Intravascular Coagulation

• Park SM
• Park JW
• Kim SM
• Koo EH
• Lee JY
• Lee CS
• Choi DC
• Lee BJ

• KMID: 2167069
• DOI: http://doi.org/10.4168/aair.2012.4.3.161

Abstract

Thromboembolism is one of the most critical complications of hypereosinophilic syndrome (HES). We report here a case of multi-organ infarctions related to HES. A 23-year-old woman was referred to our hospital with hemoptysis. Not only pulmonary, but also renal and splenic infarctions were detected on computed tomography images. Blood tests showed profound peripheral eosinophilia. She was diagnosed with HES with disseminated intravascular coagulation (DIC). We initiated infusion of corticosteroids, which effectively suppressed peripheral eosinophilia. However, consumptive coagulopathy did not improve and intracerebral hemorrhage related to thrombosis then developed. Addition of interferon-alpha resulted in the correction of the DIC associated with HES.

Keyword

Hypereosinophilic syndrome; eosinophilia; thromboembolism; disseminated intravascular coagulation; consumptive coagulopathy; interferon-alpha

MeSH Terms

Adrenal Cortex Hormones
Cerebral Hemorrhage
Dacarbazine
Disseminated Intravascular Coagulation
Eosinophilia
Female
Hematologic Tests
Hemoptysis
Humans
Hypereosinophilic Syndrome
Infarction
Interferon-alpha
Splenic Infarction
Thromboembolism
Thrombosis
Young Adult
Adrenal Cortex Hormones
Dacarbazine
Interferon-alpha

Figure

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  Fig. 1 Chest x-ray showed patchy consolidation on the right middle lobe and increased peribronchial opacity on lower bilateral lung fields (A). Chest CT showed large thrombus (arrows) in the right interlobar artery (B) and combined pulmonary infarction (arrowhead) (C). Another thrombus (arrows) was seen in the left interlobar artery (D).

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  Fig. 2 Abdominal-pelvic CT scan showed focal wedge shaped low density lesion (arrows) in the right kidney midpole (A, C) and spleen (B) suggesting infarctions.

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  Fig. 3 Disseminated intravascular coagulation profiles according to the patient progress. Platelet count, D-dimer, and fibrinogen level were gradually recovered after addition of interferon-alpha. *Gray bar, the duration of corticosteroid treatment; yellow bar, the duration of interferon-alpha treatment; INF-¶, interferon-alpha; HD, hospital day.

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