[Hypereosinophilic syndrome with first presentation of pulmonary embolism and extensive venous thrombosis: a case report and literature review].

OBJECTIVE: To study the diagnosis and treatment of hypereosinophilic syndrome complicated with thromboembolism.

METHODS: A retrospective analysis of a patient with hypereosinophilic syndrome diagnosed and treated in the Department of Cardiology, PLA General Hospital was performed. A literature research was performed with "hypereosinophilic syndrome" as the Chinese key word in Wanfang database and China national knowledge internet and "hypereosinophilic syndrome, hypereosinophilia, eosinophilia" as the English key words in PubMed and Embase database. The time interval was from January 1975 to December 2013.

RESULTS: The patient was a 31 year old male with a history of bilateral lower limb swelling and a history of chest pain accompanied with blood-stained sputum. Computed tomography pulmonary arteriography (CTPA) on admission showed multiple filling defects at lobular and segmental arteries. CT venography (CTV) and ultrasound examination of the legs demonstrated multiple venous thrombosis. Literature review found 41 articles, including 8 reviews, 29 case reports and 4 other type articles.

CONCLUSIONS: The clinical manifestations of hypereosinophilic syndrome were varied, and therefore the disease should be managed differently according to different subtypes with glucocorticoids as the main therapy. Effectively reducing the eosinophil count could decrease the incidence of thrombotic complications. Anticoagulant therapy should be used in patients with thrombotic complications. The effectiveness of preventative anticoagulation and duration of anticoagulation are less clear and require further clinical study.