Diagnosis of Hypereosinophilic Syndrome with Cardiac Involvement in a Patient with Cough and Exertional Dyspnea

Abstract

Hypereosinophilic syndrome (HES) defines a heterogeneous disease spectrum with multiorgan involvement, in which the eosinophil count in the peripheral blood is above 1500/mm3 and any parasitic, allergic and other secondary cause that may cause eosinophilia cannot be identified. HES can cause multi-organ damage and dysfunction, primarily involving the skin, heart, lungs, gastrointestinal tract, and nervous system. Cardiac involvement is a cause of high morbidity and mortality. In this article, a case with peripheral eosinophilia who presented with cough and exertional dyspnea and was diagnosed with HES with cardiac involvement in the evaluation is presented in the light of the literature.

Keywords

• Hypereosinophilic syndrome
• eozinofili
• eozinofilik miyokardit

Öksürük ve Efor Dispnesi Olan Hastada Kardiyak Tutulumlu Hipereozinofilik SendromTanısı

Abstract

Hipereozinofilik sendrom (HES) periferik kanda eozinofil sayısının 1500/mm3 üzerinde olduğu ve eozinofiliye sebep olabilecek parazitik, allerjik ve diğer ikincil bir sebebin ortaya konamadığı, multiorgan tutulumları ile seyreden heterojen bir hastalık spektrumunu tanımlar. HES başta cilt, kalp, akciğer, gastrointestinal sistem ve sinir sistemini tutan çoklu organ hasarına ve işlev bozukluğuna neden olabilir. Kardiyak tutulum ise yüksek oranda morbidite ve mortalite nedenidir. Bu yazıda, öksürük ve efor dispnesi ile başvuran ve yapılan değerlendirmede kardiyak tutulumlu HES tanısı alan, tam kan sayımında eozinofilisi olan bir olgu literatürde yer alan bilgiler eşliğinde sunulmaktadır.

Keywords

• HES
• eozinofili
• eozinofilik miyokardit

References

1. 1. Helbig G, Kyrcz-Krzemień S. Diagnostic and therapeutic management in patients with hypereosinophilic syndromes. Pol Arch Med Wewn. 2011;121(1–2):44–52.
2. 2. Crane MM, Chang CM, Kobayashi MG, Weller PF. Incidence of myeloproliferative hypereosinophilic syndrome in the United States and an estimate of all hypereosinophilic syndrome incidence. The Journal of Allergy and Clinical Immunology. 2010;126(1):179–181.
3. 3. Mankad R, Bonnichsen C, Mankad S. Hypereosinophilic syndrome: cardiac diagnosis and management. Heart. 2016;102(2):100–106.
4. 4. Roufosse F, Goldman M, Cogan E. Hypereosinophilic syndrome: lymphoproliferative and myeloproliferative variants. Semin Respir Crit Care Med. 2006;27(2):158–170.
5. 5. Ogbogu PU, Rosing DR, Horne MK 3rd. Cardiovascular manifestations of hypereosinophilic syndromes. Immunol Allergy Clin North Am. 2007;27(3):457–475.
6. 6. Legrand F, Renneville A, MacIntyre E, Mastrilli S, Ackermann F, Cayuela JM, et al. The spectrum of FIP1L1-PDGFRA-associated chronic eosinophilic leukemia: New Insights Based on a Survey of 44 Cases. Medicine (Baltimore). 2013;92(5):e1–9.
7. 7. Ogbogu PU, Bochner BS, Butterfield JH, Gleich GJ, Huss-Marp J, Kahn JE, et al. Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy. J Allergy Clin Immunol. 2009;124(6):1319-25.e3.
8. 8. Rioux JD, Stone VA, Daly MJ, Cargill M, Green T, Nguyen H, et al. Familial eosinophilia maps to the cytokine gene cluster on human chromosomal region 5q31-q33. Am J Hum Genet. 1998;63(4):1086–1094.

9. 9. Prakash Babu S, Chen Y-YK, Bonne-Annee S, Yang J, Maric I, Myers TG, et al. Dysregulation of interleukin 5 expression in familial eosinophilia. Allergy. 2017;72(9):1338–1345.
10. 10. Collins MH, Blanchard C, Abonia JP, Kirby C, Akers R, Wang N, et al. Clinical, pathologic, and molecular characterization of familial eosinophilic esophagitis compared with sporadic cases. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2008;6(6):621–629.