Scientific Reports (Mar 2021)

Venous thrombosis and predictors of relapse in eosinophil-related diseases

  • Valériane Réau,
  • Alexandre Vallée,
  • Benjamin Terrier,
  • Aurélie Plessier,
  • Noémie Abisror,
  • Félix Ackermann,
  • Ruben Benainous,
  • Gérôme Bohelay,
  • Marie-Laure Chabi-Charvillat,
  • Divi Cornec,
  • Anne-Claire Desbois,
  • Stanislas Faguer,
  • Nathalie Freymond,
  • Antoine Gaillet,
  • Mohamed Hamidou,
  • Martin Killian,
  • Sylvain Le Jeune,
  • Anne Marchetti,
  • Guy Meyer,
  • Francisco Osorio-Perez,
  • Kewin Panel,
  • Pierre-Emmanuel Rautou,
  • Julien Rohmer,
  • Nicolas Simon,
  • Colas Tcherakian,
  • Marc Vasse,
  • Elina Zuelgaray,
  • Guillaume Lefevre,
  • Jean-Emmanuel Kahn,
  • Matthieu Groh

DOI
https://doi.org/10.1038/s41598-021-85852-9
Journal volume & issue
Vol. 11, no. 1
pp. 1 – 10

Abstract

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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.