Development of Henoch-Schoenlein purpura in a child with idiopathic hypereosinophilia syndrome with multiple thrombotic onset: A case report  

作　　者：Yan-Yan Xu Xiao-Bi Huang Yun-Gong Wang Li-Yun Zheng Min Li Yu Dai Sheng Zhao 

机构地区：[1]Department of Pediatric Cardiovascular,Anhui Province Children's Hospital,Anhui Hospital of Children's Hospital Affiliated with Fudan University,Hefei 230051,Anhui Province,China [2]Department of Pediatric Intensive Care Unit,Anhui Province Children's Hospital,Anhui Hospital of Children's Hospital affiliated with Fudan University,Hefei 230051,Anhui Province,China [3]Department of Pediatrics,The Fourth Affiliated Hospital of Anhui Medical University,Hefei 230032,Anhui Province,China

出　　处：《World Journal of Clinical Cases》2023年第4期952-961,共10页世界临床病例杂志

摘　　要：BACKGROUND The incidence of pulmonary embolism(PE) in children is low, but its mortality is high. Hypereosinophilic syndrome(HES) is a group of diseases caused by an abnormal increase in eosinophilic granulocytes resulting in multiple-organ dysfunction. The urgent event of thromboembolism in the pulmonary region provoked by eosinophils in idiopathic HES(IHES) is relatively unusual. This article reports a case of IHES with multiple PEs and left leg venous thrombosis as the first manifestation. One month later, the patient developed Henoch-Schonlein purpura(HSP), which is very rare.CASE SUMMARY We report the case of a 12-year-old boy who was admitted to the hospital with dyspnea, left leg pain, and aggravation. He had bilateral PE and left leg venous embolism with mild eosinophilia. Low-molecular-weight heparin and urokinase were given. At the same time, the interventional department was contacted about filter implantation, followed by urokinase thrombolysis. The left leg thrombus was aspirated under ultrasound guidance. He was discharged from the hospital on rivaroxaban. One month later, he developed a rash on both legs and ankle pain consistent with HSP, with severe eosinophilia and motor and sensory disturbances. The patient was diagnosed with IHES with multiple embolisms complicated by HSP after excluding other causes of the eosinophil elevation. After glucocorticoid treatment, the symptoms were relieved, but the patient later developed purpura nephritis.CONCLUSION We report a rare and life-threatening case of IHES with multiple embolisms associated with HSP.A mild elevation of eosinophils early in the disease leads to difficulties in diagnosis and delayed treatment.

关 键 词：EOSINOPHIL Hypereosinophilic syndrome Henoch-Schoenlein purpura THROMBOSIS Case report 

分 类 号：R55[医药卫生—血液循环系统疾病]