Abstract
Idiopathic hypereosinophilia (IHE) and hypereosinophilic syndrome (HES) are benign haematological disorders. Studies have suggested that venous thromboembolism (VTE) is a rare but sometimes fatal complication of hypereosinophilia; however, data are limited. We retrospectively analysed clinical features and short-term outcomes of 63 consecutive patients (82.5% men; mean age, 40.92 ± 10.89 years) with IHE or HES with concurrent VTE from January 1998 through December 2018. Risk factors for pulmonary embolism (PE) were explored by multivariate logistic analysis. DVT and/or PE was detected by imaging in all patients. Independent risk factors for PE were a body mass index of >24.1 kg/m2 (odds ratio [OR]: 5.62, 95% confidence interval [CI]: 1.21–26.13, P = 0.028), peak absolute eosinophil count of >6.3 × 109/L (OR: 5.55, 95% CI: 1.292–23.875, P = 0.021), and >13.9-month duration of hypereosinophilia (OR: 4.51, 95% CI: 1.123–18.09, P = 0.034). All patients were treated with corticosteroids and anticoagulants. The short-term hypereosinophilia remission rate was 100%; no recurrent VTE or major bleeding was observed. Hypereosinophilia is a potential risk factor for VTE. PE in patients with IHE/HES and DVT is associated with a higher body mass index, higher peak absolute eosinophil count, and longer duration of hypereosinophilia. Corticosteroids and anticoagulants provided effective short-term control of hypereosinophilia and VTE.
Highlights
Previous studies have focused on thrombus formation in patients with Idiopathic hypereosinophilia (IHE)/HES3
Consecutive patients with IHE/hypereosinophilic syndrome (HES) and concurrent venous thromboembolism (VTE) (DVT and/or pulmonary embolism (PE)) who were hospitalised at Peking Union Medical College Hospital from 1 January 1998 to 31 December 2018 were identified from electronic medical records
Because no additional aetiology of VTE can be identified in many patients with IHE/HES, we hypothesised that the high level of eosinophils in the blood and tissues increases the risk of VTE in these patients
Summary
Previous studies have focused on thrombus formation in patients with IHE/HES3. A few studies have suggested that approximately 25% of patients with HES develop thromboembolic complications, with an associated mortality rate of 5% to 10%2. DVT with PE is a rare but often fatal complication of HES11. Because most reported cases lacked primary aetiologies and traditional risk factors for VTE, we hypothesised that HE may cause development of VTE. Because of the rarity and nonspecific clinical features of IHE/HES, available data on thromboembolism in patients with these disorders are limited and sporadic. Information on the clinical features and outcomes of these conditions is limited[11]. To better understand the thromboembolic complications of HE, this case series summarises the patient demographics, clinical features, and short-term clinical outcomes in patients with IHE/ HES and concurrent VTE. We explored potential risk factors for thrombotic events among patients with HE without traditional risk factors, which may provide valuable evidence for clinical practice
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