Moncayo Rita D, Sultanov Mukhammad B, Yadollahikhales Mojdeh, Tun May Thet Hmu, Azar Omar P, Pittman Meredith E, Somal Navjot K
Maimonides Medical Center, Brooklyn, NY, USA.
State University of New York Downstate Health Sciences University, Brooklyn, NY, USA.
J Investig Med High Impact Case Rep. 2025 Jan-Dec;13:23247096251342926. doi: 10.1177/23247096251342926. Epub 2025 May 31.
Secondary eosinophilia has recently gained attention as a potential contributor to vascular pathologies, including aneurysms. This case report delves into the intricate relationship between secondary eosinophilia and cerebral aneurysms, a connection yet to be fully explored in medical literature. The case centers on a 31-year-old female who presented with leg pain, a purpuric rash, and gastrointestinal symptoms following an uncomplicated pregnancy. The skin biopsy revealed perivascular and interstitial dermatitis with a significant eosinophilic infiltration of unclear etiology. Laboratory investigations showed a markedly elevated immunoglobulin E (IgE) level at 8400 kU/L. Her condition escalated to a diffuse subarachnoid hemorrhage and the discovery of a left superior cerebellar artery aneurysm. This unusual presentation, combined with the challenge of differentiating secondary eosinophilia from primary eosinophilic disorders, raises questions about the pathophysiological mechanisms and clinical implications of eosinophils in aneurysm formation. We discuss the potential link between eosinophils and vascular damage and emphasize the need for further research in understanding this association. Clinically, this case underscores the importance of considering vascular complications in patients with unexplained eosinophilia. Sharing such cases contributes to a more informed and nuanced approach to similar future presentations, guiding diagnostic and therapeutic strategies.
继发性嗜酸性粒细胞增多症最近作为血管病变(包括动脉瘤)的潜在促成因素而受到关注。本病例报告深入探讨了继发性嗜酸性粒细胞增多症与脑动脉瘤之间的复杂关系,这一联系在医学文献中尚未得到充分探索。该病例以一名31岁女性为中心,她在无并发症的妊娠后出现腿痛、紫癜性皮疹和胃肠道症状。皮肤活检显示血管周围和间质性皮炎,伴有病因不明的显著嗜酸性粒细胞浸润。实验室检查显示免疫球蛋白E(IgE)水平显著升高,达8400 kU/L。她的病情发展为弥漫性蛛网膜下腔出血,并发现左小脑上动脉瘤。这种不寻常的表现,加上区分继发性嗜酸性粒细胞增多症与原发性嗜酸性粒细胞疾病的挑战,引发了关于嗜酸性粒细胞在动脉瘤形成中的病理生理机制和临床意义的问题。我们讨论了嗜酸性粒细胞与血管损伤之间的潜在联系,并强调需要进一步研究以了解这种关联。临床上,该病例强调了在不明原因嗜酸性粒细胞增多症患者中考虑血管并发症的重要性。分享此类病例有助于对未来类似表现采取更明智和细致入微的方法,指导诊断和治疗策略。