Key result
In patients with hypereosinophilia and deep vein thrombosis, a peak absolute eosinophil count >6.2 × 10^9/L was independently associated with an increased risk of pulmonary embolism (OR 5.55).
Why the study?
Venous thromboembolism is a rare but sometimes fatal complication of hypereosinophilia, but data regarding this condition are limited.
Cohort (n=63)
No
Odds Ratio: 5.55 (95% CI 1.292–23.875)
p-value: p=0.021
In patients with hypereosinophilia and DVT, higher BMI, higher peak absolute eosinophil count, and longer duration of hypereosinophilia are independent risk factors for pulmonary embolism.
Supports heightened PE vigilance in severe hypereosinophilia with DVT; hypothesis-generating and needs prospective validation.
Idiopathic hypereosinophilia (IHE) and hypereosinophilic syndrome (HES) are benign haematological disorders. Studies have suggested that venous thromboembolism (VTE) is a rare but sometimes fatal complication of hypereosinophilia; however, data are limited. We retrospectively analysed clinical features and short-term outcomes of 63 consecutive patients (82.5% men; mean age, 40.92 ± 10.89 years) with IHE or HES with concurrent VTE from January 1998 through December 2018. Risk factors for pulmonary embolism (PE) were explored by multivariate logistic analysis. DVT and/or PE was detected by imaging in all patients. Independent risk factors for PE were a body mass index of >24.1 kg/m 2 (odds ratio [OR]: 5.62, 95% confidence interval [CI]: 1.21–26.13, P = 0.028), peak absolute eosinophil count of >6.3 × 10 9 /L (OR: 5.55, 95% CI: 1.292–23.875, P = 0.021), and >13.9-month duration of hypereosinophilia (OR: 4.51, 95% CI: 1.123–18.09, P = 0.034). All patients were treated with corticosteroids and anticoagulants. The short-term hypereosinophilia remission rate was 100%; no recurrent VTE or major bleeding was observed. Hypereosinophilia is a potential risk factor for VTE. PE in patients with IHE/HES and DVT is associated with a higher body mass index, higher peak absolute eosinophil count, and longer duration of hypereosinophilia. Corticosteroids and anticoagulants provided effective short-term control of hypereosinophilia and VTE.
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Liu et al. (2020) conducted a cohort in Idiopathic hypereosinophilia (IHE) or hypereosinophilic syndrome (HES) with concurrent venous thromboembolism (VTE) (n=63). Peak absolute eosinophil count >6.2 × 10^9/L vs. Peak absolute eosinophil count ≤6.2 × 10^9/L was evaluated on Development of pulmonary embolism (PE) (OR 5.55, 95% CI 1.292-23.875, p=0.021). In patients with hypereosinophilia and deep vein thrombosis, a peak absolute eosinophil count >6.2 × 10^9/L was independently associated with an increased risk of pulmonary embolism (OR 5.55).
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