1. Venous thrombosis and predictors of relapse in eosinophil-related diseases.
- Author
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Réau V, Vallée A, Terrier B, Plessier A, Abisror N, Ackermann F, Benainous R, Bohelay G, Chabi-Charvillat ML, Cornec D, Desbois AC, Faguer S, Freymond N, Gaillet A, Hamidou M, Killian M, Le Jeune S, Marchetti A, Meyer G, Osorio-Perez F, Panel K, Rautou PE, Rohmer J, Simon N, Tcherakian C, Vasse M, Zuelgaray E, Lefevre G, Kahn JE, and Groh M
- Subjects
- Adult, Aged, Churg-Strauss Syndrome epidemiology, Churg-Strauss Syndrome pathology, Eosinophilia complications, Eosinophilia epidemiology, Eosinophilia pathology, Eosinophils pathology, Female, Humans, Hypereosinophilic Syndrome epidemiology, Hypereosinophilic Syndrome genetics, Hypereosinophilic Syndrome pathology, Leukemia epidemiology, Leukemia genetics, Leukemia pathology, Male, Middle Aged, Portal Vein pathology, Pulmonary Embolism epidemiology, Pulmonary Embolism pathology, Pulmonary Embolism therapy, Recurrence, Retrospective Studies, Treatment Outcome, Venous Thrombosis epidemiology, Venous Thrombosis genetics, Venous Thrombosis pathology, mRNA Cleavage and Polyadenylation Factors genetics, Churg-Strauss Syndrome therapy, Eosinophilia therapy, Hypereosinophilic Syndrome therapy, Leukemia therapy, Venous Thrombosis therapy
- Abstract
Eosinophils 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.
- Published
- 2021
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