Hypereosinophilia with Concurrent Venous Thromboembolism: Clinical Features, Potential Risk Factors, and Short-term Outcomes in a Chinese Cohort

Abstract

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/m² (odds ratio [OR]: 5.62, 95% confidence interval [CI]: 1.21-26.13, P = 0.028), peak absolute eosinophil count of >6.3 × 10⁹/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.

Figure 1

Receiver operating characteristics curves and areas under the curve of three parameters related to development of pulmonary embolism. (a) shows that the cutoff value for the duration of hypereosinophilia was 13.9 months (sensitivity: 61.3%, specificity: 78.1%, P = 0.012). (b) indicates that the cutoff value for the peak absolute eosinophil count was 6.2 × 10⁹/L (sensitivity: 83.9%, specificity: 75.0%, P < 0.01). (c) shows that the cutoff value for the body mass index was 24.1 kg/m² (sensitivity: 80.6%, specificity: 62.5%, P < 0.01).