Department of Gastroenterology, Shirakawa Kosei General Hospital, Japan.
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan.
Intern Med. 2024 Sep 1;63(17):2415-2420. doi: 10.2169/internalmedicine.2989-23. Epub 2024 Feb 1.
A 46-year-old Japanese man was referred to our hospital because of a marked increase in his eosinophil count (22,870/μL) and elevated liver enzyme levels. Computed tomography (CT) showed thrombi measuring approximately 8 cm in both femoral veins. A liver biopsy revealed eosinophilic infiltration, hepatocyte necrosis, fibrosis, and multiple thrombi. We suspected acute liver injury and deep vein thrombosis associated with hypereosinophilic syndrome and initiated steroids and heparin treatment. Four days after starting treatment, the patient experienced sudden chest pain and cardiopulmonary arrest. CT revealed bilateral pulmonary artery thrombosis, and despite administration of a tissue plasminogen activator, the patient died.
一位 46 岁的日本男性因嗜酸性粒细胞计数显著升高（22,870/μL）和肝酶水平升高而被转至我院。计算机断层扫描（CT）显示双侧股静脉内血栓，大小约 8 厘米。肝活检显示嗜酸性粒细胞浸润、肝细胞坏死、纤维化和多发血栓。我们怀疑与嗜酸性粒细胞增多症相关的急性肝损伤和深静脉血栓形成，并开始使用类固醇和肝素进行治疗。治疗开始后 4 天，患者突发胸痛和心肺骤停。CT 显示双侧肺动脉血栓形成，尽管使用了组织型纤溶酶原激活物，患者还是死亡了。
