scholarly journals Venous thrombosis and predictors of relapse in eosinophil-related diseases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Valériane Réau ◽  
Alexandre Vallée ◽  
Benjamin Terrier ◽  
Aurélie Plessier ◽  
Noémie Abisror ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Eosinophil Count ◽  
Hypereosinophilic Syndrome ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Contributing Factors ◽  
Initial Manifestation ◽  
Multicenter Observational Study ◽  
Myeloid Neoplasm

AbstractEosinophils have widespread procoagulant effects. Eosinophilic cardiovascular toxicity mostly consists of endomyocardial damage or eosinophilic vasculitis, while reported cases of venous thrombosis (VT) are scarce. We aimed to report on the clinical features and treatment outcomes of patients with unexplained VT and eosinophilia, and to identify predictors of relapse. This retrospective, multicenter, observational study included patients aged over 15 years with VT, concomitant blood eosinophilia ≥ 1G/L and without any other moderate-to-strong contributing factors for VT. Fifty-four patients were included. VT was the initial manifestation of eosinophil-related disease in 29 (54%) patients and included pulmonary embolism (52%), deep venous thrombosis (37%), hepatic (11%) and portal vein (9%) thromboses. The median [IQR] absolute eosinophil count at VT onset was 3.3G/L [1.6–7.4]. Underlying eosinophil-related diseases included FIP1L1-PDGFRA-associated chronic myeloid neoplasm (n = 4), Eosinophilic Granulomatosis with Polyangiitis (n = 9), lymphocytic (n = 1) and idiopathic (n = 29) variants of hypereosinophilic syndrome. After a median [IQR] follow-up of 24 [10–62] months, 7 (13%) patients had a recurrence of VT. In multivariate analysis, persistent eosinophilia was the sole variable associated with a shorter time to VT relapse (HR 7.48; CI95% [1.94–29.47]; p = 0.015). Long-term normalization of eosinophil count could prevent the recurrence of VT in a subset of patients with unexplained VT and eosinophilia ≥ 1G/L.

scholarly journals A case of hypereosinophilic syndrome with STAT5b N642H mutation

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
Feihong Ding ◽  
Chaoping Wu ◽  
Yun Li ◽  
Sudipto Mukherjee ◽  
Subha Ghosh ◽  
...  
Keyword(s):  
Complete Blood Count ◽  
Hypereosinophilic Syndrome ◽  
Organ Damage ◽  
Myeloid Neoplasm ◽  
Acute Eosinophilic Pneumonia ◽  
Myeloid Neoplasms ◽  
Somatic Signal ◽  
Generation Sequencing

ABSTRACT Hypereosinophilia is defined as persistent eosinophilia (>1.5 × 109/L). Hypereosinophilic syndrome (HES) is a term used to describe a group of disorders characterized by sustained hypereosinophilia associated with end-organ damage. Based on underlying molecular mechanism of eosinophilia, there are different subtypes of HES. Diagnosis of HES subtype can be challenging, especially in the absence of overt lymphoid/myeloid neoplasms or discernable secondary causes. Long-term outpatient follow-up with periodic complete blood count and repeated bone marrow biopsy may be needed to monitor disease activity. Somatic signal transducer and activation transcription 5b (STAT5b) N642H mutation was recently found to be associated with myeloid neoplasms with eosinophilia. We report a case of HES who presented with pulmonary embolism and acute eosinophilic pneumonia, found to have recurrent STAT5b N642H mutation by next-generation sequencing, suggesting possible underlying myeloid neoplasm.

The Course of Intellectual Development in Preterm and Fullterm Children: An 8-year Longitudinal Study

1996 ◽  
Vol 19 (3) ◽  
pp. 491-516 ◽  
Author(s):  
Magda Kalmár
Keyword(s):  
Intellectual Development ◽  
Environmental Data ◽  
Biomedical Data ◽  
Contributing Factors ◽  
Long Term Outcomes ◽  
Long Term Follow Up ◽  
Preterm Group

A total of 55 preterm children born at low to moderate risk and a comparison group of 100 healthy fullterm children were studied until they reached 8 years of age. Perinatal biomedical data and environmental data were considered as potential contributors to developmental outcome. The Budapest Binet intelligence quotients (IQs) were used as outcome measures. The mean IQs for both groups fell within the normal range at each measurement point. However, the differential patterns of IQ development in the preterm and term group underscore the significance of the age variable. Instead of a gradually declining impact of prematurity, the age effect resulted in a complex pattern. The considerable intra-group variability within the preterm group and the correlates of outcome suggest that biological hazards related to birth may have subtle long-term influences. Variables tapping the quality of home environment, however, clearly outweighed the perinatal risk factors in their ability to predict long-term outcomes. The results suggest a transaction between the two spheres of contributing factors. Long-term follow-up studies with multiple measurement points are essential if we are to understand the developmental implications of premature birth.

Chronic Mesenteric Venous Thrombosis: Evaluation and Determinants of Survival During Long-Term Follow-up

2007 ◽  
Vol 5 (1) ◽  
pp. 80-86 ◽  
Author(s):  
David W. Orr ◽  
Phillip M. Harrison ◽  
John Devlin ◽  
John B. Karani ◽  
Pauline A. Kane ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Mesenteric Venous Thrombosis ◽  
Long Term Follow Up

scholarly journals Long-term follow-up of mandibular dental arch changes in patients with complete non-syndromic unilateral cleft lip, alveolus, and palate

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12643
Author(s):  
Sariesendy Sumardi ◽  
Benny S. Latief ◽  
Anne Marie Kuijpers-Jagtman ◽  
Edwin M. Ongkosuwito ◽  
Ewald M. Bronkhorst ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Dental Arch ◽  
Contributing Factors ◽  
Mandibular Arch ◽  
End Of Treatment ◽  
Space Closure ◽  
Long Term Follow Up ◽  
Maxillary Lateral Incisor

Background Treatment of cleft lip and palate (CLP) requires a comprehensive interdisciplinary approach and long-term follow-up. Only a few studies are available that reported on changes after treatment, which showed that in particular the transverse dimension, in patients with CLP is prone to changes after treatment. However, those studies did not pay attention to concomitant changes in the mandibular arch that occur after treatment. Objectives To evaluate mandibular transverse dental arch dimensions and interarch transverse changes in patients with complete non-syndromic unilateral cleft lip, alveolus, and palate (CUCLAP) up to five years after treatment. Material and Methods Retrospective longitudinal study in 75 consecutive patients with CUCLAP directly after comprehensive treatment (T0), two (T2), and 5 years after treatment (T5). Great Ormond Street, London and Oslo (GOSLON) scores were available for all patients. Three-dimensional scans of all dental casts were made. Inter premolar and intermolar distances between the mandibular contralateral teeth were measured. The modified Huddart Bodenham (MHB index) was applied to assess the transverse interarch relationship. Paired t-tests and ANOVA were used to analyze transverse and interarch transverse changes. Linear regression analysis was done to define contributing factors. Results Paired t-tests showed a significant decrease of the mandibular inter first and second premolar distances (p < 0.05) and an increase of the inter second molar distance, whilst the MHB Index deteriorated at all time points for all segments and for the total arch score (p < 0.05). Linear regression showed no significant contributing factors on the decrease of the transverse distances. However, inter arch transverse relationship was significantly affected by age at the end of treatment, missing maxillary lateral incisor space closure, and the GOSLON Yardstick score at the end of treatment (p < 0.05), especially during the first two years after treatment. Conclusions Changes occurred in the mandibular arch expressed as changes in the transverse dimensions and interarch relationship measured by the MHB Index. A younger age at the end of treatment, space closure for a missing maxillary lateral incisor and a higher GOSLON score at the end of treatment negatively influence the interarch transverse deterioration especially in the first two years after treatment. For the transverse dimensional changes in the mandibular arch such influencing factors could not be determined.

P4631Eosinopenia an inflammatory marker of adverse clinical outcomes in patients presenting with acute myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Alkhalil ◽  
A K Kearney ◽  
M H Hegarty ◽  
C S Stewart ◽  
P D Devlin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Clinical Outcomes ◽  
Primary Endpoint ◽  
Eosinophil Count ◽  
Systolic Function ◽  
P Value ◽  
Diabetic Patients

Abstract Background Inflammation is an indicator of worse clinical outcomes following acute myocardial infarction. Eosinopenia was identified as a surrogate of inflammation in sepsis and obstructive airway disease. Whether this readily-available marker has any impact on long term outcomes following ST-segment elevation myocardial infarction (STEMI) is yet to be determined. Purpose We sought to study the incidence and relationship between eosinopenia and infarct severity and whether low eosinophil had impact on clinical outcomes following STEMI. Methods 606 consecutive STEMI patients undergoing primary PCI from a large volume single centre were enrolled. Low eosinophil count was defined as <40 cells/ml from samples within 2 -hours post reperfusion. Primary endpoint was defined as composite of death, MI, stroke, unplanned revascularisation, re-admission for heart failure over 3.5 years follow up. Results 65% of patients had eosinopenia. Patients in the low eosinophil group had larger infarct size as measured by troponin value [2934 vs. 1177ng/L, P<0.001] and left ventricle (LV) systolic function on echocardiography [48% vs. 50%, P=0.029]. Thehre was a modest correlation between eosinophil count and both troponin (r=−0.25, P<0.001) and ejection fraction (r=0.10, P=0.017). The primary endpoint was higher in eosinopenic patients (28.8% vs. 20.4%, HR 1.49, 95% CI 1.05 to 2.13, P=0.023) (Figure). The difference was mainly driven from higher percentage of unplanned revascularisations (8.2% versus 2.9%, P=0.012) (Table). Low eosinophil count was an independent predictor of adverse cardiovascular events, beyond infarct severity, in elderly, non-diabetic patients (HR 2.04, 95% CI 1.04 to 4.01, P=0.038). Incidence rate of major clinical Clinical characteristics Low eosinophil Normal eosinophil P value Long term clinical events 28.8% (112) 20.4% (42) 0.026 Long term mortality 14.1% (55) 11.1% (23) 0.31 Long term MI 6.9% (27) 4.9% (10) 0.32 Long term unplanned revascularisation 8.2% (32) 2.9% (6) 0.012 Long term re-admission CCF 6.7% (26) 4.9% (10) 0.37 Long term stroke 2.6% (10) 1% (2) 0.19 Conclusions Eosinopenia is a readily-available marker which was associated with a larger infarcts and worse clinical outcomes over long term follow up.

Management and Outcome of Venous Thrombosis in Patients with Myeloproliferative Neoplasms: Data from the Israeli MPN Working Group

2020 ◽  
pp. 1-8
Author(s):  
Odit Gutwein ◽  
Noa Lavi ◽  
Merav Barzilai ◽  
Adi Shacham-Abulafia ◽  
Avi Leader ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Recurrent Events ◽  
Myeloproliferative Neoplasms ◽  
Antiplatelet Agents ◽  
Recurrent Event ◽  
Factors Associated ◽  
High Incidence ◽  
To Receive

The BCR-ABL-negative myeloproliferative neoplasms (MPN) are associated with high incidence of venous thrombosis and a significant rate of recurrent events, but there is no consensus regarding their management. In this retrospective study, we analyzed 96 patients with MPN-related venous thrombosis. The index venous thrombosis occurred at a median age of 58 years (IQR 37–71), with 58% of the events involving unusual sites. Patients who were on antiplatelet agents at the time of index thrombosis tended to be older than patients who were not receiving antiplatelets at the time of index thrombosis. The majority of index thromboses occurring after the diagnosis of MPN had uncontrolled blood counts at the time of event and were not receiving antithrombotic agents. Following the thrombotic episode, 75% of patients received long-term anticoagulation. At a median follow-up of 3.4 years, the recurrence rate was 14%. Thrombophilia was significantly more prevalent among patients with recurrent thrombosis compared to patients without recurrence (<i>p</i> &#x3c; 0.01). Patients who developed a recurrent event early were more likely to have thrombophilia (either inherited or antiphospholipid antibodies), and controlled blood counts, and were likely to receive anticoagulation at the time of recurrence compared to patients with later recurrences. Thrombophilia may contribute to venous thrombosis recurrence, especially early after the index venous thrombosis. Suboptimal anticoagulation and blood count control are factors associated with late venous thrombosis recurrence.

Hypereosinophilic syndrome (HES) during rituximab treatment.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e19021-e19021 ◽  
Author(s):  
Chinmay Basu
Keyword(s):  
Treatment Response ◽  
Eosinophil Count ◽  
Hypereosinophilic Syndrome ◽  
Analysis Data ◽  
Organ Damage ◽  
Full Blood Count ◽  
Severe Toxicity ◽  
Drug Induced ◽  
Post Marketing

e19021 Background: Hypereosinophilic syndrome (HES) is a rare disease defined by organ damage directly attributable to hypereosinophilia of any type. The most commonly involved organ is the lung, followed by the skin. Methods: We report a single-center cohort of patients with NHL (DLBCL). Of these patients, nine had been treated with RCHOP on standard reatment protocol (6 cycle chemotherapy). In a retrospective analysis, data on treatment response, frequency of relapses, adverse events reconstitution were evaluated. Heamotology and biochemistry tests abs analysis were performed after every cycle. Results: All patients had high disease activity before RTX treatment. We found 3 patients who developed severe drug-induced hypereosinophilia with gastrointestinal involvement as a consequence of RCHOP infusion. For the case 1 Full blood count revealed a new mild eosinophilia with eosinophil count of 1 9 109 /l. After the third infusion, the eosinophil count had risen to 7.0 9 109 /L. In case 2, after the 6th infusion, the eosinophil count had risen to 6.4 9 109/L. In case 3 also it occurred in follow up period after 6th infusion and 6.8 9 109 /L. However the finding was not associated with any severe toxicity or other malignancy. No alarming feature was also notice alongside this abnormality Conclusions: Preemptive retreatment with RTX, combined with CHOP, resulted in a sustained treatment response. Hence clinical significant is not clear this stage. Strict post marketing vigilance for evaluating the use of RCHOP was warranted.

Hypereosinophilic syndrome associated with sepsis due to Paecilomyces fungi disseminated into the liver

2016 ◽  
Vol 94 (2) ◽  
pp. 149-152
Author(s):  
Vasily M. Akhunov ◽  
A. M. Akhunova ◽  
T. P. Lavrent’eva
Keyword(s):  
Eosinophil Count ◽  
Histological Study ◽  
Hypereosinophilic Syndrome ◽  
Paecilomyces Variotii ◽  
Blood Samples ◽  
Normal Value ◽  
Clinical Recovery ◽  
Liver Biopsies

A 49 year old woman with signs of chronic sepsis, hepatomegaly, and high eosinophil count was under long-term examination including consultations with an oncologist, parasitologist, and hematologist, diagnostic laparotomy, and studies of liver biopsies. Seeding blood samples onto Saburo’s medium resulted in the growth of Paecilomyces variotii Bainier colonies. Counting mature spherules of the fungus revealed 59000 spherules per 1 mcl compared with the normal value of 1000-6000 which suggested paecilomycotic etiology of sepsis. The histological study of liver biopsies demonstrated hemorrhagic foci and eosinophilic infiltrates around fungal spherules. The clinical recovery of the patient was achieved after 3 courses of pulsed terbinafine therapy (500 mg/d every other day for 14 days during a month) in combination with vitamins and i/v infusion of 100 ml of a fluconazole solution (2 mg/ml) every third day (10 procedures during a course of therapy).

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