Department of Medicine, Nippon Life Hospital, Osaka, Osaka, Japan.
Department of Pathology, Nippon Life Hospital, Osaka, Osaka, Japan.
BMJ Case Rep. 2021 May 27;14(5):e242096. doi: 10.1136/bcr-2021-242096.
Eosinophilia in asthma or rhinitis is usually considered to be reactive to the allergic diseases. We report a 33-year-old man with asthma and rhinitis, and progressive hypereosinophilia. Fluorescence in situ hybridization analysis detected interstitial chromosomal deletion at 4q12 in cells of the bone marrow. The patient was diagnosed as myeloproliferative neoplasm with a fusion gene, and successfully treated with the tyrosine kinase inhibitor, imatinib. Clonal expansion of eosinophils due to the fusion gene could underlie refractory mechanisms in patients with bronchial asthma or allergic rhinitis.
哮喘或鼻炎中的嗜酸性粒细胞增多通常被认为是对过敏性疾病的反应。我们报告了一例 33 岁的男性哮喘和鼻炎患者,伴有进行性嗜酸性粒细胞增多。荧光原位杂交分析检测到骨髓细胞中 4q12 染色体的染色质缺失。该患者被诊断为伴有 融合基因的骨髓增殖性肿瘤,酪氨酸激酶抑制剂伊马替尼治疗有效。融合基因导致的嗜酸性粒细胞克隆性扩增可能是支气管哮喘或过敏性鼻炎患者难治机制的基础。