Top

Published in:

Open Access 01-12-2019 | Acute Kidney Injury | Case report

Acute kidney injury secondary to thrombotic microangiopathy associated with idiopathic hypereosinophilic syndrome: a case report and review of the literature

Authors: Diana Curras-Martin, Swapnil Patel, Huzaif Qaisar, Sushil K. Mehandru, Avais Masud, Mohammad A. Hossain, Gurpreet S. Lamba, Harry Dounis, Michael Levitt, Arif Asif

Published in: Journal of Medical Case Reports | Issue 1/2019

Abstract

Background

Renal involvement in idiopathic hypereosinophilic syndrome is uncommon. The mechanism of kidney damage can be explained as occurring via two distinct pathways: (1) thromboembolic ischemic changes secondary to endocardial disruption mediated by eosinophilic cytotoxicity to the myocardium and (2) direct eosinophilic cytotoxic effect to the kidney.

Case presentation

We present a case of a 63-year-old Caucasian man who presented to our hospital with 2 weeks of progressively generalized weakness. He was diagnosed with idiopathic hypereosinophilic syndrome with multiorgan involvement and acute kidney injury with biopsy-proven thrombotic microangiopathy. Full remission was achieved after 8 weeks of corticosteroid therapy.

Conclusion

Further studies are needed to investigate if age and absence of frank thrombocytopenia can serve as a prognostic feature of idiopathic hypereosinophilic syndrome, as seen in this case.

Gotlib J. World Health Organization-defined eosinophilic disorders: 2017 update on diagnosis, risk stratification, and management. Am J Hematol. 2017;92(11):1243–59.CrossRef

Shehwaro N, Langlois AL, Gueutin V, Izzedine H. Renal involvement in idiopathic hypereosinophic syndrome. Clin Kidney J. 2013;6(3):272–6.CrossRef

Liapis H, Ho AK, Graeme DB, Gleich MG. Thrombotic microangiopathy associated with the hypereosinophilic syndrome. Kidney Int. 2005;67(5):1806–11.CrossRef

Langlois AL, Shehwaro N, Rondet C, Benbrik Y, Maloum K, Gueutin V, Rouvier P, Izzedine H. Renal thrombotic microangiopathy and FIP1L1/PDGFRα-associated myeloproliferative variant of hypereosinophilic syndrome. Clin Kidney J. 2013;6(4):418–20.CrossRef

Ackerman SJ, Bochner BS. Mechanisms of eosinophilia in the pathogenesis of hypereosinophilic disorders. Immunol Allergy Clin N Am. 2007;27(3):357–75.CrossRef

Crane MM, Chang CM, Kobayashi MG. Incidence of myeloproliferative hypereosinophilic syndrome in the Unites States and an estimate of all hypereosinophilic syndrome incidence. J Allergy Clin Immunol. 2010;126:179–81.CrossRef

Weller PF, Bubley GJ. The idiopathic hypereosinophilic syndrome. J Am Soc Hematol Blood. 1994;83:2759–79.

Podjasek JC, Butterfield JH. Mortality in hypereosinophilic syndrome: 19 years of experience at Mayo Clinic with a review of the literature. Leuk Res. 2013;37(4):392–5.CrossRef

Thomas LL, Page SM. Inflammatory cell activation by eosinophil granule proteins. Chem Immunol. 2000;76:99–117.CrossRef

10.

Spry CJ. Hypereosinophilic syndrome: clinical features, laboratory findings and treatment. Allergy. 1982;37:539–51.CrossRef

11.

Shah TH, Koul AN, Shah S, Khan UH, Koul PA, Sofi FA, Mufti S, Jan RA. Idiopathic hypereosinophilic syndrome presenting as IgA Nephropathy with nephrotic range proteinuria. Open J Nephrol. 2013;3(2):101–3.CrossRef

12.

Bulucu F, Can C, Inal V, Baykal Y, Erikçi S. Renal involvement in a patient with idiopathic hypereosinophilic syndrome. Clin Nephrol. 2002;57(2):171–3.CrossRef

13.

Richardson P, Dickinson G, Nash S, Hoffman L, Steingart R, Germain M. Crescentic glomerulonephritis and eosinophilic interstitial infiltrates in a patient with hypereosinophilic syndrome. Postgrad Med J. 1995;71(833):175–8.CrossRef

14.

Choi YJ, Lee JD, Yang KI, et al. Immunotactoid glomerulopathy associated with idiopathic hypereosinophilic syndrome. Am J Nephrol. 1998;18:337–43.CrossRef

15.

Motellon JL, Bernis, Garcia-Sanchez A, Gruss E, Tarver JA. Renal involvement in the hypereosinophilic syndrome: case report. Nephrol Dial Transplant. 1995;10:401–3.PubMed

16.

Navarro I, Torras J, Goma M, Cruzado JM, Grinyó JM. Renal involvement as the first manifestation of hypereosinophilic syndrome: a case report. NDT Plus. 2009;2(5):379–81.PubMedPubMedCentral

17.

Smith A, Fernando SL. Renal infarction in hypereosinophilic syndrome. Intern Med J. 2012;42:1162–3.CrossRef

18.

Garella G, Marra L. Hypereosinophilic syndrome and renal insufficiency [in Italian]. Minerva Urol Nefrol. 1990;42:135–6.PubMed

19.

Ohguchi H, Sugawara T, Harigae H. Thrombotic thrombocytopenic purpura complicated with hypereosinophilic syndrome. Inter Med. 2009;48:1687–90.CrossRef

20.

Hirszel P, Cashell AW, Whelan TV, et al. Urinary Charcot-Leyden crystals in the hypereosinophilic syndrome with acute renal failure. Am J Kidney Dis. 1988;12:319–22.CrossRef

21.

Frigui M, Hmida MB, Jallouli M, et al. Membranous glomerulopathy associated with idiopathic hypereosinophilic syndrome. Saudi J Kidney Dis Transpl. 2010;21:320–2.PubMed

22.

Asif A, Ali Nayer A, Haas CS. Atypical hemolytic uremic syndrome in the setting of complement-amplifying conditions: case reports and a review of the evidence for treatment with eculizumab. J Nephrol. 2017;30(3):347–62.CrossRef

23.

Dejman A, Alavi SN, Thomas DB, Stefanovic A, Asif A, Nayer A. The potential role of complements in cocaine-induced thrombotic microangiopathy. Clin Kidney J. 2018;11(1):26–8.CrossRef

24.

Ogbogu PU, Bochner BS, Butterfield JH, Gleich GJ, Huss-Marp J, Kahn JE, Leiferman KM, Nutman TB, Pfab F, Ring J, Rothenberg ME, Roufosse F, Sajous MH, Sheikh J, Simon D, Simon HU, Stein ML, Wardlaw A, Weller PF, Klion AD. Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy. J Allergy Clin Immunol. 2009;124(6):1319–25.CrossRef

25.

Cools J, DeAngelo DJ, Gotlib J, Stover EH, Legare RD, Cortes J, Kutok J, Clark J, Galinsky I, Griffin JD, Cross NC, Tefferi A, Malone J, Alam R, Schrier SL, Schmid J, Rose M, Vandenberghe P, Verhoef G, Boogaerts M, Wlodarska I, Kantarjian H, Marynen P, Coutre SE, Stone R, Gilliland DG. A tyrosine kinase created by fusion of the PDGFRA and FIP1L1 genes as a therapeutic target of imatinib in idiopathic hypereosinophilic syndrome. N Engl J Med. 2003;348(13):1201–14.CrossRef

Title: Acute kidney injury secondary to thrombotic microangiopathy associated with idiopathic hypereosinophilic syndrome: a case report and review of the literature
Authors: Diana Curras-Martin
Swapnil Patel
Huzaif Qaisar
Sushil K. Mehandru
Avais Masud
Mohammad A. Hossain
Gurpreet S. Lamba
Harry Dounis
Michael Levitt
Arif Asif
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Acute Kidney Injury
Thrombotic Microangiopathy
Acute Kidney Injury
Published in: Journal of Medical Case Reports / Issue 1/2019
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-019-2187-4

At a glance: The STEP trials

Springer Medicine

Acute kidney injury secondary to thrombotic microangiopathy associated with idiopathic hypereosinophilic syndrome: a case report and review of the literature

Abstract

Background

Case presentation

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case presentation

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2019

An iliopsoas abscess caused by Parvimonas micra: a case report

Delayed hemolysis, elevated liver enzymes, low platelet count syndrome in succession of switches of preventive anticoagulant treatment in a 41-year-old patient with a history of recurrent assisted implantation failures: a case report

Occlusive radiation cerebral vasculopathy implies medical complexity: a case report

Strongyloides stercoralis infection after the use of emergency corticosteroids: a case report on hyperinfection syndrome

Sclerosing peritonitis presenting as complete mechanical bowel obstruction: a case report

Epilepsia partialis continua complicated by disseminated tuberculosis and hemophagocytic lymphohistiocytosis: a case report