Key result
Corticosteroid therapy successfully ameliorated intradialytic hypotension, myocardial injury, and other symptoms alongside reductions in eosinophil counts in three hemodialysis patients with idiopathic hypereosinophilic syndrome.
Why the study?
There have been few case reports of idiopathic hypereosinophilic syndrome in hemodialysis patients, and recording clinical findings and treatments is needed to establish optimal management.
Does prednisolone improve symptoms and biomarkers in hemodialysis patients with idiopathic hypereosinophilic syndrome?
Case Report (n=3)
No
Does prednisolone improve symptoms and biomarkers in hemodialysis patients with idiopathic hypereosinophilic syndrome?
Corticosteroid therapy with prednisolone effectively resolved intradialytic hypotension and myocardial injury in hemodialysis patients with idiopathic hypereosinophilic syndrome.
May support corticosteroid trial for intradialytic hypotension in hypereosinophilic hemodialysis patients; hypothesis-generating and requires prospective confirmation.
RATIONALE: Herein, we report 3 hemodialysis patients with idiopathic hypereosinophilic syndrome who were successfully treated using corticosteroid therapy. PATIENT CONCERNS: Case 1 was a 63-year-old man who was undergoing hemodialysis because of bilateral nephrectomy and developed hypereosinophilia with digestive symptoms, myocardial injury, and intradialytic hypotension. Case 2 was an 83-year-old man who was undergoing hemodialysis because of nephrosclerosis and developed hypereosinophilia with pruritus, myocardial injury, and intradialytic hypotension. Case 3 was a 59-year-old man who was undergoing hemodialysis because of diabetic nephropathy and developed hypereosinophilia with pruritus, myocardial injury, and intradialytic hypotension. DIAGNOSES: All 3 patients presented with hypereosinophilia (eosinophil count ≥1500 /μL for more than 1 month) and multiple-organ involvement (intradialytic hypotension, cardiac injury, digestive symptoms, and allergic dermatitis). A specific cause for the hypereosinophilia was not identified by systemic computed tomography, electrocardiography, echocardiography, bone marrow examination, or blood tests. Furthermore, Case 2 and 3 had not recently started taking any new drugs and drug-induced lymphocyte stimulation tests were negative in Case 1. Therefore, they were diagnosed with idiopathic hypereosinophilic syndrome. INTERVENTIONS: All 3 patients received corticosteroid therapy with prednisolone at a dose of 40 mg/d, 30 mg/d, and 60 mg/d in Case 1, 2, and 3, respectively. OUTCOMES: Their digestive symptoms, pruritus, intradialytic hypotension, and serum troponin I concentrations were immediately improved alongside reductions in their eosinophil counts. LESSONS: There have been few case reports of idiopathic hypereosinophilic syndrome in patients undergoing hemodialysis. We believe that recording of the clinical findings and treatments of such patients is mandatory to establish the optimal management of idiopathic hypereosinophilic syndrome.
No takes yet. Share an insight, caveat, or question.
Mutsuyoshi et al. (2021) conducted a case report in Idiopathic hypereosinophilic syndrome (n=3). Corticosteroid therapy (prednisolone) was evaluated on Symptom resolution and reduction in eosinophil count and serum troponin I. Corticosteroid therapy successfully ameliorated intradialytic hypotension, myocardial injury, and other symptoms alongside reductions in eosinophil counts in three hemodialysis patients with idiopathic hypereosinophilic syndrome.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: