Chen Hao, Raza Hafiz Khuram, Jing Jia, Shen Dayong, Xu Peng, Zhou Su, Zu Jie, Yang Xinxin, Zhang Wei, Zhang Shenyang, Hua Fang, Cui Guiyun
a Department of Neurology , The Affiliated Hospital of Xuzhou Medical University , Xuzhou , China.
b Department of Biology , Georgia State University , Atlanta , USA.
Brain Inj. 2017;31(12):1695-1700. doi: 10.1080/02699052.2017.1357835. Epub 2017 Sep 25.
To report two cases of hypereosinophilic syndrome (HES) with central nervous system involvement and explore its possible pathogenesis.
We have analysed the clinical data and relevant features of two patients who presented themselves to The Affiliated Hospital of Xuzhou Medical University between 2012 and 2015. We have reviewed the relevant literature, elaborated the possible pathogenesis, and discussed the treatment options.
Both patients had consistently high levels of absolute eosinophil count which led to multiple cerebral infarcts in the arterial border zone and small-vessel disease. Blood tests were taken several times during their course of disease showing elevated eosinophils. Both patients underwent head computed tomography (CT), magnetic resonance imaging, and magnetic resonance angiography, which indicated small-vessel disease and watershed infarction. Glucocorticoids, improvement cycle, and neuro-nutrition treatments resulted in a significant improvement of their clinical state.
HES can involve central nervous system by causing small-vessel disease and watershed infarction, which can be its presenting features. Repeated blood tests should be done to rule out HES in central nervous system lesion.
报告2例伴有中枢神经系统受累的嗜酸性粒细胞增多综合征（HES）病例，并探讨其可能的发病机制。
我们分析了2012年至2015年间在徐州医科大学附属医院就诊的2例患者的临床资料及相关特征。我们回顾了相关文献，阐述了可能的发病机制，并讨论了治疗方案。
2例患者的绝对嗜酸性粒细胞计数持续高水平，导致动脉边缘区多发性脑梗死和小血管疾病。在病程中多次进行血液检查，显示嗜酸性粒细胞升高。2例患者均接受了头部计算机断层扫描（CT）、磁共振成像和磁共振血管造影，结果显示小血管疾病和分水岭梗死。糖皮质激素、改善循环及神经营养治疗使他们的临床状态有显著改善。
HES可通过引起小血管疾病和分水岭梗死累及中枢神经系统，这可能是其表现特征。对于中枢神经系统病变患者，应反复进行血液检查以排除HES。
