Published: 2020-10-28

Hypereosinophilia presented as thromboembolic event: a rare manifestation

Sudhir K. Atri, Homdutt ., Manjri Goel, Devender Yadav


Eosinophilia refers to peripheral blood absolute eosinophil count above the ULN, normal range of AEC is 0.05-0.5× 109/l (1-6%). Hyper eosinophilia refers to AEC above 1.5×109/l. Hypereosinophilia can affect multiple organs and can cause cardiomyopathy, gastroenteritis, cutaneous lesions, pneumonitis, and neuritis. In addition, some patients develop thromboembolic complications. We are presenting a case who presented to us with thromboembolic complication later diagnosed as hypereosinophilia with Bone marrow showing myeloid associated eosinophilia (Primary eosinophilia).


Eosinophilia, Deep vein thrombosis, Pulmonary embolism, Thromboembolism

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Lippi GI, Montagnana M, Salvagno GI, Franchini M, Targher G, Guidi GC, Eosinophilia and first-line coagulation testing, J. Thromb Haemost. 2013;11 (3):412–22.

Bain BJ. Chronic eosinophilic leukemia, not otherwise specified. World Health Organization Classification of Tumors of Haematopoietic and Lymphoid Tissues. 2008:51-3.

Sato Y, Fukunaga T, Hayashi T, Asada Y. Hypereosinophilic syndrome associated with occlusive coronary thrombosis and right ventricular thrombus. Pathol Int. 2008;58:138-41.

Uemura K, Nakajima M, Yamauchi N, Fukayama M, Yoshida K. Sudden death of a patient with primary hypereosinophilia, colon tumours, and pulmonary emboli. J Clin Pathol. 2004;57:541-3.

Sherer Y, Salomon O, Livneh A, Pras M, Langevitz P. Thromboembolism in a patient with transient eosinophilia and thrombocytopenia. Clin Lab Haematol. 2000;22:247-9.

Klion AD, Bochner BS, Gleich GJ, Nutman TB, Rothenberg ME, Simon HU, et al. Hypereosinophilic Syndromes Working Group. Approaches to the treatment of hypereosinophilic syndromes: a workshop summary report. J Aller Clinic Immunol. 2006;117(6):1292-302.

Roufosse F, Weller PF. Practical approach to the patient with hypereosinophilia. J Aller Clinic Immunol. 2010;126(1):39-44.

Mukai HY, Ninomiya H, Ohtani K, Nagasawa T, Abe T. Major basic protein binding to thrombomodulin potentially contributes to the thrombosis in patients with eosinophilia. Brit J Haematol. 1995;90(4):892-9.

Baccarani M, Cilloni D, Rondoni M, Ottaviani E, Messa F, Merante S, et al. The efficacy of imatinib mesylate in patients with FIP1L1-PDGFRα-positive hypereosinophilic syndrome. Results of a multicenter prospective study. Haematol. 2007;92(9):1173-9.

Walz C, Erben P, Ritter M, Bloor A, Metzgeroth G, Telford N, et al. Response of ETV6-FLT3–positive myeloid/lymphoid neoplasm with eosinophilia to inhibitors of FMS-like tyrosine kinase 3. Blood, The Journal of the American Society of Hematology. 2011;118(8):2239-42.