Hypereosinophilia presenting as eosinophilic vasculitis and multiple peripheral artery occlusions without organ involvement

Sung Hwan Kim, Tae Bum Kim, Young Sun Yun, Jung-Im Shin, Il Young Oh, Jung Ju Sir, Kyung Mook Kim, Hye Kyung Park, Hye Ryun Kang, Yoon Seok Chang, Yoon Keun Kim, Sang Heon Cho, Yeong Wook Song, Dong Chul Choi, Kyung Up Min, You Young Kim

Research output: Contribution to journalArticle

Abstract

We report here a case with hypereosinophilia and peripheral artery occlusion. A 32-yr-old Korean woman presented to us with lower extremity swelling and pain. Angiography revealed that multiple lower extremity arteries were occlusive. The biopsy specimen showed perivascular and periadnexal dense eosinophilic infiltration in dermis and subcutaneous adipose tissue. Laboratory investigations revealed a persistent hypereosinophilia. She was prescribed prednisolone 60 mg daily. Her skin lesion and pain were improved and the eosinophil count was dramatically decreased. After discharge, eosinophil count gradually increased again. Cyanosis and pain of her fingers recurred. She had been treated with cyclophosphamide pulse therapy. Her eosinophilia was decreased, but the cyanosis and tingling sense were progressive. The extremity arterial stenoses were slightly progressed. Skin biopsy showed perivascular eosinophilic infiltration in the dermis and CD40 ligand (CD40L) positive eosinophilic infiltration. The serum TNF-α was markedly increased. These results suggest that CD40L (a member of TNF-α superfamily) could play a role in the inflammatory processes when eosinophil infiltration and activation are observed. We prescribed prednisolone, cyclophosphamide, clopidogrel, cilostazol, beraprost and nifedipine, and she was discharged.

Original languageEnglish (US)
Pages (from-to)677-679
Number of pages3
JournalJournal of Korean Medical Science
Volume20
Issue number4
DOIs
StatePublished - Jan 1 2005
Externally publishedYes

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Vasculitis
Eosinophils
CD40 Ligand
Cyanosis
beraprost
Arteries
clopidogrel
Dermis
Prednisolone
Pain
Cyclophosphamide
Lower Extremity
Biopsy
Skin
Subcutaneous Fat
Eosinophilia
Nifedipine
Fingers
Angiography
Pathologic Constriction

Keywords

  • CD40 Ligand
  • Hypereosinophilic Syndrome
  • Tumor Necrosis Factor-alpha
  • Vasculitis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hypereosinophilia presenting as eosinophilic vasculitis and multiple peripheral artery occlusions without organ involvement. / Kim, Sung Hwan; Kim, Tae Bum; Yun, Young Sun; Shin, Jung-Im; Oh, Il Young; Sir, Jung Ju; Kim, Kyung Mook; Park, Hye Kyung; Kang, Hye Ryun; Chang, Yoon Seok; Kim, Yoon Keun; Cho, Sang Heon; Song, Yeong Wook; Choi, Dong Chul; Min, Kyung Up; Kim, You Young.

In: Journal of Korean Medical Science, Vol. 20, No. 4, 01.01.2005, p. 677-679.

Research output: Contribution to journalArticle

Kim, SH, Kim, TB, Yun, YS, Shin, J-I, Oh, IY, Sir, JJ, Kim, KM, Park, HK, Kang, HR, Chang, YS, Kim, YK, Cho, SH, Song, YW, Choi, DC, Min, KU & Kim, YY 2005, 'Hypereosinophilia presenting as eosinophilic vasculitis and multiple peripheral artery occlusions without organ involvement', Journal of Korean Medical Science, vol. 20, no. 4, pp. 677-679. https://doi.org/10.3346/jkms.2005.20.4.677
Kim, Sung Hwan ; Kim, Tae Bum ; Yun, Young Sun ; Shin, Jung-Im ; Oh, Il Young ; Sir, Jung Ju ; Kim, Kyung Mook ; Park, Hye Kyung ; Kang, Hye Ryun ; Chang, Yoon Seok ; Kim, Yoon Keun ; Cho, Sang Heon ; Song, Yeong Wook ; Choi, Dong Chul ; Min, Kyung Up ; Kim, You Young. / Hypereosinophilia presenting as eosinophilic vasculitis and multiple peripheral artery occlusions without organ involvement. In: Journal of Korean Medical Science. 2005 ; Vol. 20, No. 4. pp. 677-679.
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AU - Kim, Sung Hwan

AU - Kim, Tae Bum

AU - Yun, Young Sun

AU - Shin, Jung-Im

AU - Oh, Il Young

AU - Sir, Jung Ju

AU - Kim, Kyung Mook

AU - Park, Hye Kyung

AU - Kang, Hye Ryun

AU - Chang, Yoon Seok

AU - Kim, Yoon Keun

AU - Cho, Sang Heon

AU - Song, Yeong Wook

AU - Choi, Dong Chul

AU - Min, Kyung Up

AU - Kim, You Young

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N2 - We report here a case with hypereosinophilia and peripheral artery occlusion. A 32-yr-old Korean woman presented to us with lower extremity swelling and pain. Angiography revealed that multiple lower extremity arteries were occlusive. The biopsy specimen showed perivascular and periadnexal dense eosinophilic infiltration in dermis and subcutaneous adipose tissue. Laboratory investigations revealed a persistent hypereosinophilia. She was prescribed prednisolone 60 mg daily. Her skin lesion and pain were improved and the eosinophil count was dramatically decreased. After discharge, eosinophil count gradually increased again. Cyanosis and pain of her fingers recurred. She had been treated with cyclophosphamide pulse therapy. Her eosinophilia was decreased, but the cyanosis and tingling sense were progressive. The extremity arterial stenoses were slightly progressed. Skin biopsy showed perivascular eosinophilic infiltration in the dermis and CD40 ligand (CD40L) positive eosinophilic infiltration. The serum TNF-α was markedly increased. These results suggest that CD40L (a member of TNF-α superfamily) could play a role in the inflammatory processes when eosinophil infiltration and activation are observed. We prescribed prednisolone, cyclophosphamide, clopidogrel, cilostazol, beraprost and nifedipine, and she was discharged.

AB - We report here a case with hypereosinophilia and peripheral artery occlusion. A 32-yr-old Korean woman presented to us with lower extremity swelling and pain. Angiography revealed that multiple lower extremity arteries were occlusive. The biopsy specimen showed perivascular and periadnexal dense eosinophilic infiltration in dermis and subcutaneous adipose tissue. Laboratory investigations revealed a persistent hypereosinophilia. She was prescribed prednisolone 60 mg daily. Her skin lesion and pain were improved and the eosinophil count was dramatically decreased. After discharge, eosinophil count gradually increased again. Cyanosis and pain of her fingers recurred. She had been treated with cyclophosphamide pulse therapy. Her eosinophilia was decreased, but the cyanosis and tingling sense were progressive. The extremity arterial stenoses were slightly progressed. Skin biopsy showed perivascular eosinophilic infiltration in the dermis and CD40 ligand (CD40L) positive eosinophilic infiltration. The serum TNF-α was markedly increased. These results suggest that CD40L (a member of TNF-α superfamily) could play a role in the inflammatory processes when eosinophil infiltration and activation are observed. We prescribed prednisolone, cyclophosphamide, clopidogrel, cilostazol, beraprost and nifedipine, and she was discharged.

KW - CD40 Ligand

KW - Hypereosinophilic Syndrome

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