Journal of Inflammation Research (Nov 2022)

Resolved Hypereosinophilic Syndrome and Immune Thrombocytopenic Purpura in Ulcerative Colitis Patients Post Colectomy: A Case Series and Literature Review

  • Subki AH,
  • Bokhary MI,
  • Alandijani SA,
  • Aljehani MA,
  • Alharbi AW,
  • Alzahrani M,
  • Almuhammadi SS,
  • Albeirouti BT,
  • Abduljabar MA,
  • Danese S

Journal volume & issue
Vol. Volume 15
pp. 6373 – 6380

Abstract

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Ahmed Hussein Subki,1 Manal Ismail Bokhary,1 Sultan Abdulrahman Alandijani,1 Mohannad Abdulrahman Aljehani,1 Ahmed Wasel Alharbi,1 May Alzahrani,1 Saud Suliman Almuhammadi,2 Bassim Tahseen Albeirouti,3 Mohamed Abdulmajid Abduljabar,1 Silvio Danese4 1Department of Internal Medicine, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia; 2Department of Surgery, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia; 3Adult Hematology/Bone Marrow Transplant (BMT) Section, Department of Oncology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia; 4Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, ItalyCorrespondence: Ahmed Hussein Subki; Manal Ismail Bokhary, Department of Internal Medicine, King Faisal Specialist Hospital & Research Centre, P.O.Box No 40047, Jeddah, 21499, Saudi Arabia, Email [email protected]; [email protected]: Hypereosinophilic syndrome (HES) and immune thrombocytopenic purpura (ITP) have been reported to co-occur with ulcerative colitis (UC). However, the exact pathogenic mechanisms of their occurrence remain elusive. In this article, we aim to describe two cases of UC patients who developed refractory HES and ITP and elaborate on their potential pathogenesis.Case Study: We report two middle-aged patients diagnosed with UC. The first patient developed HES that was refractory to conventional medical therapy of idiopathic HES, and the second developed refractory ITP that failed steroid and immunosuppressive therapy. Both conditions improved considerably following colectomy, suggesting they are of a reactive rather than idiopathic nature.Conclusion: In patients with UC and refractory comorbid HES or ITP, the reactive nature of these comorbidities should be taken into consideration, and colectomy, therefore, should be considered if clinically indicated.Keywords: hypereosinophilic syndrome, immune thrombocytopenic purpura, colectomy, ulcerative colitis

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