Clinical analysis of six eosinophilia cases with L?effler endocarditis as the main clinical feature
10.3760/cma.j.cn121090-20250106-00008
- VernacularTitle:以L?effler心内膜炎为主要临床特征的嗜酸性粒细胞增多症6例临床分析
- Author:
Ma Ya' NAN
1
;
Suning CHEN
;
Bingyuan ZHOU
;
Xiaofei YANG
Author Information
1. 苏州大学附属第一医院血液科，江苏省血液研究所，国家血液系统疾病临床医学研究中心，国家卫生健康委员会血栓与止血重点实验室，苏州 215006
- Publication Type:Journal Article
- From:
Chinese Journal of Hematology
2025;46(9):854-859
- CountryChina
- Language:Chinese
-
Abstract:
To improve the understanding of L?effler endocarditis, we retrospectively analyzed six patients with eosinophilia, predominantly characterized by L?effler endocarditis, who were treated at the First Affiliated Hospital of Soochow University from January 2019 to October 2024. Among the 6 patients, 5 were male, with a median age of 45.5 years (31–77 years). All patients demonstrated increased white blood cell count and eosinophil count in peripheral blood. Clinical symptoms and imaging examination were considered as L?effler endocarditis, and two cases were complicated by cerebral infarction. Fusion gene testing was completed in five patients, with cases 4 and 5 demonstrating FIP1L1::PDGFRA fusion gene positivity, and case 6 with TLS::ERG (+) acute myeloid leukemia. Two patients with FIP1L1::PDGFRA positivity achieved rapid remission after imatinib treatment. Case 6 experienced symptom relief after glucocorticoids and hydroxyurea treatment, followed by complete remission after chemotherapy with the cytarabine (20 mg q12 h × 14 days), idarubicin (5 mg on days 2–12 every other day), and G-CSF (adjusted based on blood counts) regimen. After 8 months, the patient underwent allogeneic hematopoietic stem cell transplantation but died 1 year post-transplantation due to disease relapse complicated by infection. The remaining three patients demonstrated improvement after glucocorticoid treatment. Except for case 6, the other patients were still alive, with case 4 relapsing at 28 months after imatinib discontinuation and relieved after treatment re-initiation.
