Journal of Medical Case Reports (Sep 2019)

Acute kidney injury secondary to thrombotic microangiopathy associated with idiopathic hypereosinophilic syndrome: a case report and review of the literature

  • Diana Curras-Martin,
  • Swapnil Patel,
  • Huzaif Qaisar,
  • Sushil K. Mehandru,
  • Avais Masud,
  • Mohammad A. Hossain,
  • Gurpreet S. Lamba,
  • Harry Dounis,
  • Michael Levitt,
  • Arif Asif

DOI
https://doi.org/10.1186/s13256-019-2187-4
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 6

Abstract

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Abstract Background Renal involvement in idiopathic hypereosinophilic syndrome is uncommon. The mechanism of kidney damage can be explained as occurring via two distinct pathways: (1) thromboembolic ischemic changes secondary to endocardial disruption mediated by eosinophilic cytotoxicity to the myocardium and (2) direct eosinophilic cytotoxic effect to the kidney. Case presentation We present a case of a 63-year-old Caucasian man who presented to our hospital with 2 weeks of progressively generalized weakness. He was diagnosed with idiopathic hypereosinophilic syndrome with multiorgan involvement and acute kidney injury with biopsy-proven thrombotic microangiopathy. Full remission was achieved after 8 weeks of corticosteroid therapy. Conclusion Further studies are needed to investigate if age and absence of frank thrombocytopenia can serve as a prognostic feature of idiopathic hypereosinophilic syndrome, as seen in this case.

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