1Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
The first case, 27-year-old man was referred to our hospital for a dyspnea workup. The echocardiogram revealed severe tricuspid valve regurgitation and moderate mitral valve regurgitation. A valvuloplasty was performed and dizziness developed after the surgery. Brain magnetic resonance imaging revealed microbleeding in the right temporo-occipital lobe. He was referred to the hemato-oncology department for evaluation of eosinophilia. The laboratory findings were as follows: WBC count, 21.1×109/L (eosinophil count, 13.0×109/L); Hb, 9.1 g/dL; and platelet count, 99.0×109/L. In addition, parasite antibodies for
The second case, 23-year-old man was referred to our hospital for a workup as eosinophilia had been detected in a routine health checkup. The laboratory findings were as follows: WBC count, 70.0×109/µL (eosinophil count, 55.3×109/L); Hb, 10.1 g/dL; and platelet count, 131.0×109/L. The number of eosinophils in the peripheral blood smear was increased (Fig. 1C). In the bone marrow aspirate, 90% of all nucleated cells were eosinophils. Infiltration by eosinophils was observed in the bone marrow section (Fig. 1D). Conventional cytogenetic analysis revealed a normal karyotype (46,XY) and FISH for
The initial clinical manifestation of HES involves dermatologic, pulmonary, and gastrointestinal symptoms . However, the presence of neurologic or cardiac signs and symptoms increases with disease progression or delayed diagnosis . Severe cardiac complications include endomyocardial fibrosis, valve scarring, and embolism. Our patients also showed dyspnea, cardiac signs (valve regurgitation), and renal involvement (Case 1). Therefore, clinicians need to be alert for the presence
In conclusion, we report 2 cases of CEL with the
Peripheral blood (PB) smear and bone marrow (BM) aspirate findings of first case
Fluorescence in situ hybridization (FISH) for the FIP1L1-PDGFRA rearrangement, and reverse transcription - polymerase chain reaction (RT-PCR) and sequencing analysis.