嗜酸性粒细胞增多是一种罕见的疾病,定义为绝对嗜酸性粒细胞计数持续升高大于1.5x109/L和/或组织嗜酸性粒细胞增多。这种情况可能是由许多不同的病因引起的,血液学(克隆)和非血液学(反应性)。反应性嗜酸性粒细胞增多症包括所有疾病,包括感染。嗜酸性粒细胞增多症患者可能由于多器官损伤而经历一系列临床后果,包括神经系统和血栓性并发症,与器官功能障碍和潜在危及生命的后遗症有关。脑静脉血栓形成(CVT)是用于描述脑中静脉和/或静脉窦的血栓性闭塞的术语。这种情况可能发生在所有年龄段,与嗜酸性粒细胞增多有关的CVT是一种罕见的疾病。由于血栓形成会导致脑引流阻塞,因此必须迅速进行疾病诊断。静脉充血,脑脊液重吸收中断,缺血性神经元损伤,脑水肿,出血,导致严重的神经系统并发症.由于嗜酸性粒细胞增多引起的CVT颅内出血的管理对于临床医生来说是一项具有挑战性的任务。基于抗凝治疗,全身性皮质类固醇,颅内压升高的管理,以及抗凝剂引起的潜在进行性出血。患者的预后通常取决于早期检测,提示,和适当的治疗。在这个案例报告中,我们讨论了一例罕见的儿童CVT伴嗜酸性粒细胞增多和登革热血清学阳性,在颅内出血的情况下,启发了在这个复杂场景的管理中考虑个性化策略的重要性。
Hypereosinophilia is a rare condition, defined as a persistent elevation of absolute eosinophil count greater than 1.5x109/L and/or tissue eosinophilia. This condition can be caused by numerous different etiologies, both hematological (clonal) and non-hematological (reactive). Reactive
hypereosinophilia encompasses all disorders, including infections. Patients with
hypereosinophilia may experience a spectrum of clinical consequences due to multiple organ damage, including neurologic and thrombotic complications, associated with organ dysfunction and potentially life-threatening sequelae. Cerebral venous thrombosis (CVT) is the term used to describe thrombotic occlusion of veins and/or venous sinuses in the brain. This condition can occur at all ages and CVT related to
hypereosinophilia is a rare disease. Diagnosis of the disease must be done quickly because thrombosis causes blockage of cerebral drainage, venous congestion, disruption of cerebrospinal fluid reabsorption, ischemic neuronal damage, cerebral edema, and hemorrhage, leading to severe neurological complications. Management of intracranial hemorrhage from CVT due to hypereosinophilia is a challenging task for clinicians, based on anticoagulation therapy, systemic corticosteroid, management of elevated intracranial pressure, and potentially progressive hemorrhage due to anticoagulant. The outcome of the patient generally relies on early detection, prompt, and appropriate treatment. In this case report, we discuss a rare case of CVT with
hypereosinophilia and positive dengue serology in a child, in the context of intracranial hemorrhage, enlightening the importance of considering a personalized strategy in the management of this complex scenario.