Chronic Eosinophillic Leukemia presenting as Peripheral Neuropathy

Abstract

Chronic Eosinophilic Leukemia (CEL) is a rare form of chronic myeloproliferative disorder of unknown etiology with no data on its true incidence. The disease has a wide variety of manifestations. Literature search has not shown peripheral neuropathy as the only presentation of CEL. Our case is probably the first such report case. Here we are reporting a 45 year old male patient who presented with progressive weakness of upper and lower limbs for 6 months and weight loss for 2 months. Neurological examination revealed findings consistent with bilateral sensorimotor polyneuropathy later confirmed by nerve conduction studies. Complete blood count revealed total wbc count – 51, 870/mm3, eosinophil – 62.1% (32,315/mm3). Peripheral Blood film revealed eosinophilic leucocytosis. Superficial peroneal nerve biopsy showed mild perivascular infiltration with inflammatory cells. No granuloma or malignancy was seen. Bone Marrow examination showed hyperactive granulopoiesis with predominance of eosinophil series with progressive maturation along with presence of myeolcytes, hypersegmented eosinophils and giant eosinophils. Blast cell was around 7%. Patient was treated with imatinib and prednisolone which showed excellent response.Bangladesh Crit Care J March 2018; 6(1): 47-49